Home›Rheumatology› AML infiltration of bile duct identified as primary cause of acute pancreatitis in case report
AML infiltration of bile duct identified as primary cause of acute pancreatitis in case reportLeukemia Cells Found as Cause of Severe Pancreatitis
Frontiers in MedicinePublished August 3, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider AML in the workup of acute pancreatitis when typical etiologies are absent, especially with hematologic abnormalities.
This is a case report and literature review describing a 34-year-old man with acute pancreatitis and type 2 diabetes mellitus, in whom acute myeloid leukemia (AML) was identified as the primary cause of pancreatitis. The diagnosis was established through bone marrow aspirate and smear examination, after excluding other typical etiologies. The patient presented with elevated serum lipase levels, leukocytosis, severe thrombocytopenia, necrotizing pancreatitis, and stenosis of the pancreatic segment of the common bile duct, consistent with AML infiltration of that segment.
The authors report that AML infiltration of the pancreatic segment of the common bile duct was the primary cause of acute pancreatitis in this patient. This is an uncommon mechanism, as leukemic infiltration of the pancreas is rare. The case underscores the need to consider acute leukemia, particularly AML, in the etiological workup of acute pancreatitis, especially when no other cause is apparent.
As a single case report, the evidence is limited by the small sample size (1 case) and the inherent lack of generalizability. The authors do not report follow-up data, adverse events, or funding sources. The certainty of the conclusion is low, and the association between AML and pancreatitis is based on clinical judgment rather than a controlled comparison.
For clinicians, this report suggests that in patients with acute pancreatitis and hematologic abnormalities, a search for an underlying leukemia may be warranted. However, given the rarity and the low level of evidence, this should not alter routine practice but rather serve as a diagnostic consideration in atypical presentations.
How this fits prior evidence
This case report extends prior coverage by highlighting a rare non-metabolic cause of acute pancreatitis in a patient with type 2 diabetes, contrasting with prior items that focused on glycemic management (culturally tailored interventions, mHealth apps, SGLT2 inhibitors). It also complements the prior case of Ph+ leukemia by illustrating another hematologic malignancy presenting with organ-specific complications. The finding underscores the importance of considering hematologic causes in atypical pancreatitis, a gap not addressed in prior diabetes-focused coverage.
Doctors reported on a 34-year-old man who suffered from acute pancreatitis and type 2 diabetes. While many things can cause pancreatic inflammation, this patient had no typical causes. Testing revealed that his condition was actually caused by the infiltration of leukemia cells into the bile duct area.
The study highlights how certain blood cancers can present in unusual ways. In this specific case, the patient showed high lipase levels and severe low platelet counts. The findings suggest that doctors should consider looking for underlying blood cancers when a patient has unexplained, severe inflammation of the pancreas.
Because this report involves only one patient, the evidence is limited. It does not mean leukemia is a common cause of pancreatitis, but it shows how rare cases can sometimes hide an underlying condition. Patients with unusual symptoms should discuss their specific results and potential underlying causes with their medical team.
What this means for you:
A single case suggests that leukemia can be an underlying cause of severe inflammation in the pancreas.
Common questions
What caused the patient's pancreatitis?
The primary cause was identified as acute myeloid leukemia (AML). The leukemic cells infiltrated the pancreatic segment of the common bile duct, leading to severe inflammation and complications like necrotizing pancreatitis.
Who did this finding affect?
This case specifically involved a 34-year-old man with type 2 diabetes. It highlights that leukemia should be considered in the workup for any patient presenting with acute pancreatitis who has no other clear cause.
Is this a common way for leukemia to cause symptoms?
No, it is not common. The report notes that leukemia is an uncommon cause of acute pancreatitis through direct pancreatic infiltration by leukemic cells. Because this was a single case report, the evidence is limited.
BackgroundAcute myeloid leukemia (AML) presenting with acute pancreatitis (AP) as the initial symptom is extremely rare. Severe AP (SAP) has a significant death rate and advances quickly. Therefore, it is crucial to identify the predisposing factors in the early stages of SAP, assess the condition, establish the prognosis, develop treatment plans and prevent a recurrence. Here, we describe a case of AP associated with AML infiltration involving the pancreatic segment of the common bile duct.Case summaryA 34-year-old man arrived to the hospital complaining of persistent abdominal pain. Blood analysis presented elevated serum lipase levels, leukocytosis, and severe thrombocytopenia. Computed tomography examination of the abdomen revealed necrotizing pancreatitis, accompanied by significant stenosis of the pancreatic segment of the common bile duct due to extrinsic compression, and moderate dilatation of the proximal bile duct and intrahepatic biliary ducts. The patient had no typical etiologies of acute pancreatitis except a history of type 2 diabetes mellitus, which alone could not account for the significant thrombocytopenia observed concurrently. Finally, the bone marrow aspirate and smear examination identified the acute myeloid leukemia (AML) which was considered as the primary cause of pancreatitis.ConclusionAcute leukemia, particularly AML, is an uncommon cause of AP via direct pancreatic infiltration by leukemic cells. Although AP rarely presents as an extramedullary manifestation in AML patients, it should be considered in the etiological workup of AP. Early recognition and targeted etiological management can optimize clinical outcomes and prevent ineffective treatment.
