Guang-Xian Wang1,2, Jun-Lin Liao1,3, Dong Zhang1,2, Li Wen4,5. 1. , Chongqing, China. 2. Department of Radiology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China. 3. Department of Surgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, 1422 JCP Iowa City, IA, 52242, Washington D.C., USA. 4. , Chongqing, China. cqzdwl@163.com. 5. Department of Radiology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China. cqzdwl@163.com.
Abstract
BACKGROUND: Relapse of acute lymphoblastic leukemia (ALL) in the pancreas is rare. We report a case of a 12-year-old boy who experienced a relapse of ALL in the pancreas after a bone marrow transplant. METHODS: Clinical data, including course of illness, laboratory results, and imaging studies are included. The patient presented with acute pancreatitis, suspected to be secondary to gallstones, with ampullary obstruction. Ultrasound and magnetic resonance imaging demonstrated a distended gallbladder and intra- and extra-hepatic biliary dilatation with a cutoff at the pancreatic head, but with no evidence of gallstones. RESULTS: Ultrasound-guided biopsy of the pancreas revealed ALL in the pancreas. Systematic chemotherapy was recommended, but was declined by the parents. The patient died one week later. CONCLUSION: Relapse of ALL in the pancreas is rare, but when a history of ALL is present, it should be considered in patients with pancreatic enlargement, obstructive jaundice, and pancreatitis.
BACKGROUND: Relapse of acute lymphoblastic leukemia (ALL) in the pancreas is rare. We report a case of a 12-year-old boy who experienced a relapse of ALL in the pancreas after a bone marrow transplant. METHODS: Clinical data, including course of illness, laboratory results, and imaging studies are included. The patient presented with acute pancreatitis, suspected to be secondary to gallstones, with ampullary obstruction. Ultrasound and magnetic resonance imaging demonstrated a distended gallbladder and intra- and extra-hepatic biliary dilatation with a cutoff at the pancreatic head, but with no evidence of gallstones. RESULTS: Ultrasound-guided biopsy of the pancreas revealed ALL in the pancreas. Systematic chemotherapy was recommended, but was declined by the parents. The patient died one week later. CONCLUSION: Relapse of ALL in the pancreas is rare, but when a history of ALL is present, it should be considered in patients with pancreatic enlargement, obstructive jaundice, and pancreatitis.
Authors: Eugene K Choi; Jae Ho Byun; Soon Jin Lee; Seung Eun Jung; Mi-Suk Park; Seong Ho Park; Moon-Gyu Lee Journal: AJR Am J Roentgenol Date: 2007-06 Impact factor: 3.959