Chronic lymphocytic leukemia manifesting as ischemic colitis - 22/08/11
Doi : 10.1016/j.gie.2006.08.040
| Commentary CLL may manifest in the colon in several ways, all of which are uncommon and in none of which is the diagnosis immediately apparent: perforation, obstruction, and intussusception, the latter 2 especially with Richter’s syndrome (transformation of CLL to large-cell lymphoma); bleeding from leukemic tissue infiltration, with or without associated vasculopathy, such as watermelon rectum, vascular ectasia, and now ischemia; and infectious (viral or fungal) complications of immunocompromise, either from the disease itself or its therapy. Colon ischemia with CLL conceivably could result from amyloidosis or hyperviscosity syndrome or, as usual, be a localized bout of nonocclusive small-vessel disease. To paraphrase the English psychologist Edward de Bono, sometimes a diagnostic dilemma is only a problem because the findings are looked at and interpreted in a certain way. Looked at in another way, the right course of action may be so obvious that the problem no longer exists. Unfortunately for this patient, the pathologist established the cause of the problem, and prognosis did not benefit from accurate diagnosis. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2007
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 65 - N° 6
P. 919-920 - mai 2007 Retour au numéro
Article précédent
- Protein-losing enteropathy from eosinophilic enteritis diagnosed by wireless capsule endoscopy and double-balloon enteroscopy
- Surakit Pungpapong, Mark E. Stark, John R. Cangemi
- Intussusception and bleeding of a Meckel’s diverticulum diagnosed by colonoscopy
- Tamás Molnár, Ferenc Nagy, János Lonovics, László Tiszlavicz
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