Leukemic Infiltration of the Appendix as an Unusal Site of Extramedulary Relapse: Report of Two Cases and Review of the Literature
Authors: Mahdi Shahriari, Mohammadreza Bordbar, Bita Geramizadeh, Mehran Karimi
Abstract: The appendix is an unusual site for extramedulary relapse of acute leukemia. The present case report describes two cases of late course acute lymphoblastic leukemia presented with leukemic infiltration of the appendix and complete remission of bone marrow. The signs and symptoms of the cases suggest that leukemic involvement of the appendix should be considered in the differential diagnosis of leukemia patients presenting with acute abdomen
ran J Med Sci 2010; 35(3): 248-250.
Keywords: Acute lymphoblastic leukemia, appendix , Appendicitis
Introduction: Acute leukemia is the most frequent malignancy of the child- hood. Increased survival and prolonged remission of leukemic patients, as a result of modern combined anticancer therapies, has led to more frequent extramedulary infiltration of leukemic cells.1 However, the involvement of the appendix in leukemia is extremely rare, especially when the disease is diagnosed ante-mortem or when a patient"s bone marrow (BM) is in remission.
Only sporadic reports of the antemortem recognition of leukemic appendiceal involvement have appeared in the literature.2-6
The present report describes the clinicopathologic features
of two cases of acute lymphoblastic leukemia (ALL), while in complete BM remission, presented with leukemic involvement of the appendix and acute abdominal pain, which mimicked acute appendicitis requiring prompt appendectomy.