Abstract
Chronic lymphocytic leukemia (CLL) is the most common lymphoproliferative disorder in the United States. It has a variable presentation with most patients having asymptomatic lymphocytosis. Many other patients present with lymphadenopathy or enlargement of other organs of the reticuloendothelial system. However, CLL can present with extramedullary involvement. Most commonly, this is in the form of skin or central nervous system involvement, though rarely it can present with gastrointestinal involvement. Here, we present the case of a 70-year-old Caucasian male who presented with chronic diarrhea for over 4 months. After failing conservative treatment, a colonoscopy was performed which showed diffuse mucosal nodularities with a biopsy revealing CLL. The patient was treated successfully with chemotherapy and his diarrhea improved. This is a differential to keep in mind in patients with chronic diarrhea, once the more common causes have been ruled out.
Highlights
B-cell chronic lymphocytic leukemia (CLL) is the most common form of leukemia in the United States, accounting for almost 25 to 30% of all leukemias [1]
It most commonly affects elderly patients with a median age of diagnosis being 70 years of age [2]. e presentation of Chronic lymphocytic leukemia (CLL) can be very variable ranging from asymptomatic lymphocytosis to painless lymphadenopathy, hepatomegaly, splenomegaly, cytopenias, and infections
While gastrointestinal involvement can occur rarely in patients with CLL, it mostly occurs in patients with Richter’s transformation and is very unusual to occur in patients with CLL [4]
Summary
B-cell chronic lymphocytic leukemia (CLL) is the most common form of leukemia in the United States, accounting for almost 25 to 30% of all leukemias [1]. CLL is a progressive accumulation of functionally inert lymphocytes in the blood, lymphoid tissues, and bone marrow. It most commonly affects elderly patients with a median age of diagnosis being 70 years of age [2]. A 70-year-old Caucasian male presented with complaints of diarrhea for the last 4 months He had associated fecal urgency and incontinence at times. He was having 4-5 bowel movements a day ranging from semisolid to watery stools. He denied any history of fevers, abdominal pain, vomiting, weight loss, night sweats, or skin rashes. He denied any recent travel history or exposure to anyone with similar symptoms
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