H. Lee Moffitt Cancer Center & Research Institute

Imaging in Oncology


Robert Clark, MD
Professor of Radiology
Chief, Radiology Service
H. Lee Moffitt Cancer Center Research Institute.


Case Description:

A 44­year­old man developed right lower quadrant abdominal pain while undergoing intensive chemotherapy for acute myeloblastic leukemia. He had loose bowel movements without blood in his stool. Physical examination revealed a body temperature of 37.8°C and right lower quadrant tenderness without mass or rebound tenderness. The blood count showed hemoglobin 9.4 mg/dL, white cells 800/mm-cubed, and platelets 80,000/mm-cubed.

The abdominal radiography and computed tomography are shown in Fig 1. The best diagnosis is:

1. appendicitis
2. cecal intramural hemorrhage
3. neutropenic colitis (typhlitis)
4. ischemic colitis
5. gastrointestinal leukemia

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