Colonic infiltration with chronic myelomonocytic leukemia.

BACKGROUND

A 75-year-old female presented with a 1 month history of non-bloody diarrhea, associated with abdominal cramping and urgency. Her medical history was notable for chronic myelomonocytic leukemia, diagnosed 6 years previously and managed expectantly by monitoring the patient's complete blood count. Over several months, the patient's symptoms progressed, which resulted in significant weight loss. The patient's course of disease was ultimately complicated by acute disseminated encephalomyelitis and death.

INVESTIGATIONS: Physical examination, laboratory investigations, stool studies, colonoscopy with biopsies, immunohistochemistry and pathologic review of biopsy specimens.

DIAGNOSIS: Leukemic colitis.

MANAGEMENT: Management of underlying leukemia with systemic hydroxyurea and topical colonic 5-aminosalicylic acid therapy.