B Cell Acute Lymphocytic Leukemia Presenting as a Bile Duct Stricture Diagnosed With Cholangioscopy

Abstract

Indeterminate biliary strictures represent a diagnostic challenge requiring further work-up, which encompasses a variety of diagnostic modalities. We report a very rare case of B-cell acute lymphocytic leukemia presenting as a biliary stricture following remission of acute myeloid leukemia, which was initially treated with allogenic stem cell transplant. After multiple diagnostic modalities were implemented with no success, the use of cholangioscopy-guided biopsies was the key for the final diagnosis.

T-Lymphoblastic lymphoma presenting with obstructive jaundice and pleural effusion; role of flow cytometry on pleural fluid: A case report

“…2,3 Table 1 highlights features of these two cases, and those of ours. Jaundice has also been reported in B-ALL/LBL, more than T-ALL/LBL; [4][5][6][7][8] and in acute myeloid leukemia. 9,10 The cause of obstructive jaundice, in a case of leukemia/lymphoma, can be either due to, obstruction of hepato-biliary tract (extra-/intra-hepatic), 10 or due to leukemic infiltration of hepatic sinusoids.…”

B-lymphoblastic leukaemia presenting as intrahepatic cholestasis

“…The pathophysiology of obstructive jaundice in patients with acute lymphoblastic leukaemia (ALL) can vary. It can encompass a spectrum of mechanisms, ranging from the obstruction of the biliary duct, as observed in a case of acute myeloid leukaemia [8] , formation of a bile duct stricture in a case of B-ALL [18] , to the infiltration of hepatic sinusoids by tumour cells, as seen in the present case. According to certain authors [8] , prednisone can be considered before initiating chemotherapy as a treatment approach.…”