Obstructive Jaundice as a Presenting Symptom of Acute Lymphocytic Leukemia in Adults: A Case Report.

We present a unique case of acute lymphoblastic leukemia in an adult. A 58-year-old male presented complaining of epigastric pain. He was initially diagnosed with obstructive jaundice, as indicated by an elevated ratio of direct bilirubin to total bilirubin levels. Bone marrow aspirate revealed hypercellular marrow with heavy infiltration of blast cells. The target cells were positive for CD20 by immunostaining. This finding is consistent with acute lymphoblastic leukemia B cell type. This case emphasizes that acute lymphoblastic leukemia can exhibit a wide range of symptoms and should be considered a differential diagnosis, especially when encountering atypical obstructive jaundice.