Gastrointestinal Involvement in a Patient with Chronic Lymphocytic Leukemia

• Published in: Balkan medical journal Vol. 37; no. 1; pp. 50 - 51
• Main Authors: Çabuk, Devrim, Ballı, Fatih, Yılmaz, Yasin, Duman, Ali Erkan, Uygun, Kazım
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Yayinevi Tic. Ltd 01.01.2020; Trakya Üniversitesi; Galenos Publishing; Galenos Publishing House
• Subjects: Aged; Chronic lymphocytic leukemia; Clinical Image; Dyspnea - etiology; Fatigue; Fatigue - etiology; Gastrointestinal Diseases - diagnostic imaging; Gastrointestinal Diseases - etiology; Gastroscopy - methods; Humans; Immunoglobulins; Leukemia, Lymphoid - complications; Leukemia, Lymphoid - diagnosis; Leukemia, Lymphoid - diagnostic imaging; Lymphocytes; Lymphocytic leukemia; Male; Tıp; Tomography, X-Ray Computed - methods; White blood cell count; Türkiye; Edirne; Chronic Lymphocytic Leukemia
• ISSN: 2146-3123; 2146-3131
• DOI: 10.4274/balkanmedj.galenos.2019.2019.9.51

A 70-year-old man was admitted to the hospital with symptoms of fatigue and dyspnea. A total blood count showed leukocytosis with an increased lymphocyte count. In a short time, his white blood cell (WBC) count had increased to 200 000 (WBC: 217.00×109/L, lym: 175.00×109/L, and neu: 22.30×109/L) and flow cytometry revealed a phenotype that was positive for CD20, CD19, and CD5 and negative for FMC7. CD 23 was highly positive (70.09%), and there was co-expression of CD5 and CD19 (68.46%). Surface membrane immunoglobulin levels were low (5.27%). This phenotype was typical of a diagnosis of chronic lymphocytic leukemia (CLL). Abdominal and thorax computerized tomography (CT) revealed hepatosplenomegaly, peritoneal carcinomatosis, para-aortic and celiac lymphadenopathies, and diffuse wall thickening in the rectum. The patient was referred to the medical oncology department with a diagnosis of rectal cancer and peritoneal metastasis. A CT of the thorax showed bilateral pleural effusion and nodular lesions in the bilateral lung parenchyma.