title: Relapse of acute lymphoblastic leukemia in the pancreas after bone marrow transplant.
abstract: BACKGROUND
  Relapse of acute lymphoblastic leukemia (ALL) in the pancreas is rare. We report a case of a 12-year-old boy who experienced a relapse of ALL in the pancreas after a bone marrow transplant.
  
  
  METHODS
  Clinical data, including course of illness, laboratory results, and imaging studies are included. The patient presented with acute pancreatitis, suspected to be secondary to gallstones, with ampullary obstruction. Ultrasound and magnetic resonance imaging demonstrated a distended gallbladder and intra- and extra-hepatic biliary dilatation with a cutoff at the pancreatic head, but with no evidence of gallstones.
  
  
  RESULTS
  Ultrasound-guided biopsy of the pancreas revealed ALL in the pancreas. Systematic chemotherapy was recommended, but was declined by the parents. The patient died one week later.
  
  
  CONCLUSIONS
  Relapse of ALL in the pancreas is rare, but when a history of ALL is present, it should be considered in patients with pancreatic enlargement, obstructive jaundice, and pancreatitis.
authors: , Chongqing, China.|Department of Radiology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors: Guang-Xian
authors: GX
authors: Wang
authors: , Chongqing, China.|Department of Surgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, 1422 JCP Iowa City, IA, 52242, Washington D.C., USA.
authors: Jun-Lin
authors: JL
authors: Liao
authors: , Chongqing, China.|Department of Radiology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors: Dong
authors: D
authors: Zhang
authors: , Chongqing, China. cqzdwl@163.com.|Department of Radiology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China. cqzdwl@163.com.
authors: Li
authors: L
authors: Wen
mesh_terms: D016026:Bone Marrow Transplantation; D002648:Child; D003952:Diagnostic Imaging; D017809:Fatal Outcome; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology* / Q000628:therapy
keywords: acute lymphoblastic leukemia; leukemic infiltration; pancreas; relapse