Obstructive jaundice due to a pancreatic mass: a rare presentation of acute lymphoblastic leukaemia in an adult.

Abstract

CONTEXT:

To highlight a rare presentation of acute lymphoblastic leukaemia.

CASE REPORT:

A 39-year-old man presented with a 4 month history of weight loss and a 6 week history of upper abdominal pain radiating to the back with nausea and vomiting. Liver function tests showed an obstructive picture, full blood count was normal and on computerised tomography there was diffuse enlargement of the pancreas, with dilatation of the common bile duct and intra hepatic biliary radicles. Four weeks after presenting, the white cell count became elevated with blasts on the blood film and bone marrow biopsy revealed a precursor B cell acute lymphoblastic leukaemia. After induction chemotherapy his jaundice resolved, the pancreatic mass reduced in size and he is now in a complete remission.

CONCLUSION:

Acute lymphoblastic leukaemia may mimic common causes of a pancreatic mass such as adenocarcinoma and should be considered as part of the differential diagnosis when atypical features are present.

• Authors: Sudin Varghese Daniel, Deven Harshad Vani, Andrew Melvin Smith, Quentin Antony Hill, Krishna Viswanath Menon
• Journal: JOP : Journal of the pancreas (JOP) Vol. 11 Issue 1 Pg. 72-4 (Jan 08 2010) ISSN: 1590-8577 [Electronic] Italy
• PMID: 20065559 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Diagnosis, Differential
• Humans
• Jaundice, Obstructive (diagnosis, etiology, pathology)
• Male
• Organ Size
• Pancreas (pathology)
• Pancreatic Diseases (complications, diagnosis, pathology)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications, diagnosis)