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Published in: Digestive Diseases and Sciences 2/2019

01-02-2019 | Stanford Multidisciplinary Seminars

Blood and Guts: Diarrhea from Colonic Involvement in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Authors: Thomas A. Zikos, George Triadafilopoulos, Caroline Berube, Kirsten A. Regalia

Published in: Digestive Diseases and Sciences | Issue 2/2019

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Excerpt

An 81-year-old male was initially evaluated in a local emergency department for a 6-week history of diarrhea. He had a history of coronary artery disease with remote coronary artery bypass graft and mechanical mitral valve placement, for which he was maintained on warfarin. He also had chronic obstructive pulmonary disease with chronic hypoxemic respiratory insufficiency for which he received continuous oxygen at a rate of 2 L/min. Prior to the onset of diarrhea, he had no chronic gastrointestinal (GI) symptoms. The diarrhea began acutely, was non-bloody, and eventually progressed to more than ten bowel movements daily. While he denied abdominal pain, fevers, chills, or nausea, he sustained a 10-pound weight loss during this time. There was no family history of inflammatory bowel disease. …
Literature
5.
go back to reference Ratterman M, Kruczek K, Sulo S, Shanafelt TD, Kay NE, Nabhan C. Extramedullary chronic lymphocytic leukemia: systematic analysis of cases reported between 1975 and 2012. Leuk Res. 2014;38:299–303.CrossRefPubMed Ratterman M, Kruczek K, Sulo S, Shanafelt TD, Kay NE, Nabhan C. Extramedullary chronic lymphocytic leukemia: systematic analysis of cases reported between 1975 and 2012. Leuk Res. 2014;38:299–303.CrossRefPubMed
6.
go back to reference Faigel DO, Vaughn DJ, Furth EE, Metz DC. Chronic lymphocytic leukemia: an unusual cause of upper gastrointestinal hemorrhage. Am J Gastroenterol. 1995;90:635–637.PubMed Faigel DO, Vaughn DJ, Furth EE, Metz DC. Chronic lymphocytic leukemia: an unusual cause of upper gastrointestinal hemorrhage. Am J Gastroenterol. 1995;90:635–637.PubMed
7.
go back to reference Kuse R, Lueb H. Gastrointestinal involvement in patients with chronic lymphocytic leukemia. Leukemia. 1997;11:S50–S51.PubMed Kuse R, Lueb H. Gastrointestinal involvement in patients with chronic lymphocytic leukemia. Leukemia. 1997;11:S50–S51.PubMed
8.
go back to reference Rao V, Watkins R, Kaleem A, Cooke J, Wedgwood K. Leukaemic infiltration of gall bladder—unusual presentation of occult chronic lymphocytic leukaemia. J Surg Case Rep. 2011;2011:7.PubMedPubMedCentral Rao V, Watkins R, Kaleem A, Cooke J, Wedgwood K. Leukaemic infiltration of gall bladder—unusual presentation of occult chronic lymphocytic leukaemia. J Surg Case Rep. 2011;2011:7.PubMedPubMedCentral
9.
go back to reference Costa F, Choy CG, Seiter K, Hann L, Thung SN, Michaeli J. Hepatic outflow obstruction and liver failure due to leukemic cell infiltration in chronic lymphocytic leukemia. Leuk Lymphoma. 1998;30:403–410.CrossRefPubMed Costa F, Choy CG, Seiter K, Hann L, Thung SN, Michaeli J. Hepatic outflow obstruction and liver failure due to leukemic cell infiltration in chronic lymphocytic leukemia. Leuk Lymphoma. 1998;30:403–410.CrossRefPubMed
10.
go back to reference Cresson DH, Siegal GP. Chronic lymphocytic leukemia presenting as an anal mass. J Clin Gastroenterol. 1985;7:83–87.CrossRefPubMed Cresson DH, Siegal GP. Chronic lymphocytic leukemia presenting as an anal mass. J Clin Gastroenterol. 1985;7:83–87.CrossRefPubMed
11.
go back to reference Goncalves R, Sousa R, Banhudo A, Pereira E, Pereira R, Castel-Branco Silveira J. Endoscopic findings in chronic lymphocytic leukemia. Am J Clin Oncol. 2000;23:599–601.CrossRefPubMed Goncalves R, Sousa R, Banhudo A, Pereira E, Pereira R, Castel-Branco Silveira J. Endoscopic findings in chronic lymphocytic leukemia. Am J Clin Oncol. 2000;23:599–601.CrossRefPubMed
12.
13.
go back to reference Malhotra P, Singh M, Kochhar R, et al. Leukemia infiltration of bowel in chronic lymphocytic leukemia. Gastrointest Endosc. 2005;62:614–615.CrossRefPubMed Malhotra P, Singh M, Kochhar R, et al. Leukemia infiltration of bowel in chronic lymphocytic leukemia. Gastrointest Endosc. 2005;62:614–615.CrossRefPubMed
14.
go back to reference Arkkila PE, Nuutinen H, Ebeling F, Elonen E, Karkkainen P, Karjalainen-Lindsberg ML. Colonic involvement in a patient with chronic lymphocytic leukaemia. Gastroenterol Res Pract. 2008;2008:742146.CrossRefPubMedPubMedCentral Arkkila PE, Nuutinen H, Ebeling F, Elonen E, Karkkainen P, Karjalainen-Lindsberg ML. Colonic involvement in a patient with chronic lymphocytic leukaemia. Gastroenterol Res Pract. 2008;2008:742146.CrossRefPubMedPubMedCentral
15.
go back to reference Lalani M, Rhee JC, Gutkin DW, Matin K, Ahmad J. Uncommon presentations of some common malignancies: case 3. Chronic lymphocytic leukemia involving the colon and presenting with perforation. J Clin Oncol. 2005;23:1315–1317.CrossRefPubMed Lalani M, Rhee JC, Gutkin DW, Matin K, Ahmad J. Uncommon presentations of some common malignancies: case 3. Chronic lymphocytic leukemia involving the colon and presenting with perforation. J Clin Oncol. 2005;23:1315–1317.CrossRefPubMed
16.
go back to reference Shim CS, Kim JO, Cheon YK, Cho JY, Lee JS, Lee MS. A case of chronic lymphocytic leukemia-complicated colonic intussusception. Gastrointest Endosc. 2001;54:77–78.CrossRefPubMed Shim CS, Kim JO, Cheon YK, Cho JY, Lee JS, Lee MS. A case of chronic lymphocytic leukemia-complicated colonic intussusception. Gastrointest Endosc. 2001;54:77–78.CrossRefPubMed
17.
go back to reference Assarzadegan N, Montgomery E, Anders RA. Immune checkpoint inhibitor colitis: the flip side of the wonder drugs. Virchows Arch. 2018;472:125–133.CrossRefPubMed Assarzadegan N, Montgomery E, Anders RA. Immune checkpoint inhibitor colitis: the flip side of the wonder drugs. Virchows Arch. 2018;472:125–133.CrossRefPubMed
18.
go back to reference Weidner AS, Panarelli NC, Geyer JT, et al. Idelalisib-associated colitis: histologic findings in 14 patients. Am J Surg Pathol. 2015;39:1661–1667.CrossRefPubMed Weidner AS, Panarelli NC, Geyer JT, et al. Idelalisib-associated colitis: histologic findings in 14 patients. Am J Surg Pathol. 2015;39:1661–1667.CrossRefPubMed
19.
go back to reference Innocenti I, Autore F, Pasquale R, Morelli F, Efremov DG, Laurenti L. Treatment approach for elderly and unfit patients with chronic lymphocytic leukemia. Expert Rev Hematol. 2017;10:1069–1076.CrossRefPubMed Innocenti I, Autore F, Pasquale R, Morelli F, Efremov DG, Laurenti L. Treatment approach for elderly and unfit patients with chronic lymphocytic leukemia. Expert Rev Hematol. 2017;10:1069–1076.CrossRefPubMed
20.
go back to reference Gosangi B, Davids M, Somarouthu B, et al. Review of targeted therapy in chronic lymphocytic leukemia: what a radiologist needs to know about CT interpretation. Cancer Imaging. 2018;18:13.CrossRefPubMedPubMedCentral Gosangi B, Davids M, Somarouthu B, et al. Review of targeted therapy in chronic lymphocytic leukemia: what a radiologist needs to know about CT interpretation. Cancer Imaging. 2018;18:13.CrossRefPubMedPubMedCentral
21.
go back to reference Burger JA, O’Brien S. Evolution of CLL treatment—from chemoimmunotherapy to targeted and individualized therapy. Nat Rev Clin Oncol. 2018;15:510–527.CrossRefPubMed Burger JA, O’Brien S. Evolution of CLL treatment—from chemoimmunotherapy to targeted and individualized therapy. Nat Rev Clin Oncol. 2018;15:510–527.CrossRefPubMed
22.
go back to reference Forconi F, Moss P. Perturbation of the normal immune system in patients with CLL. Blood. 2015;126:573–581.CrossRefPubMed Forconi F, Moss P. Perturbation of the normal immune system in patients with CLL. Blood. 2015;126:573–581.CrossRefPubMed
Metadata
Title
Blood and Guts: Diarrhea from Colonic Involvement in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Authors
Thomas A. Zikos
George Triadafilopoulos
Caroline Berube
Kirsten A. Regalia
Publication date
01-02-2019
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 2/2019
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5264-4

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