INTRODUCTION
Hematologic malignancies (HM) represent a burden on the health care
system worldwide, mainly due to their prevalence among the pediatric
population, and have always been well recognized among other types of
cancer by the effective use of genetic analyses to establish the
diagnosis, classification and prognosis (1). HM include leukemias,
lymphomas, myeloproliferative neoplasms (MPNs), mast cell neoplasms,
plasma cell neoplasms, histiocytic tumors, and dendritic cell neoplasms.
However, leukemias and lymphomas comprise the majority of malignant
cases, with acute lymphoblastic leukemia being the most common
malignancy in children (2). Chronic leukemias include lymphocytic and
myelogenous leukemias, which carries an overall more benign course than
acute leukemias and occurs typically in the adult population (3).
Chronic myeloid/ myelogenous leukemia (CML) is one of the MPNs and
accounts for 15% of newly diagnosed leukemia in adults; it is
characterized by the presence of BCR-ABL1 fusion oncogene; this
rearrangement is known as the Philadelphia chromosome (4). CML can range
from an asymptomatic course, which accounts for almost 50% of cases
diagnosed in the United States, to a wide array of signs and symptoms,
including fatigue, weight loss, fever, abdominal discomfort, and many
other manifestations (4). Among the various presentations,
gastrointestinal (GI) involvement has been well recognized, though it is
more common in acute leukemias than chronic, and is becoming even less
common due to improved chemotherapy (5).
Here we present a case of a 36-year-old male who presented with right
lower abdominal pain and was accidentally found to have a very high
white blood cell (WBC) count during routine workup 317.3
x109/L (4-10 x109/L).