Acute Appendicitis in a Child With Acute Leukemia and Chemotherapy-Induced Neutropenia: A Case Report and Literature Review

Abstract

Acute appendicitis is a rare but important complication in children with leukemia. It can be difficult to diagnose, and it has a complicated disease course, especially in patients receiving chemotherapy. Awareness of these complications is critical, particularly in cases where surgical intervention is required. We report a child with T-cell acute lymphoblastic leukemia and chemotherapy-induced neutropenia who presented with acute appendicitis. He was successfully treated with broad-spectrum empiric antibiotics and a delayed laparoscopic appendectomy.

Keywords: acute leukemia; appendicitis; chemotherapy-induced neutropenia.

Figure 1. CT of the abdomen.

(A) Coronal CT scan image. (B) Axial CT scan image. Images show a dilated, thick-walled appendix measuring up to 7 mm (red arrows) with peri-appendicular inflammatory fat stranding and minimal free fluid.

Figure 2. Hemotoxylin and eosin (H&E)-stained section of the appendix.

(A) Low power view (H&E, original magnification x40). The image shows an appendiceal mucosa with mucosal erosions, submucosal lymphoid aggregates (blue arrows), and transmural acute inflammatory cell infiltrate. (B) Higher power view (H&E, original magnification x100). The mucosa shows ulcerations with cryptitis and crypt abscesses (yellow arrow).