Incidental Colonic Masses, Cytomegalovirus Infection, and Amyloidosis in a Treatment-Naive Chronic Lymphocytic Leukemia (CLL) Patient without GI Symptoms.

Gastrointestinal (GI) involvement by chronic lymphocytic leukemia (CLL) is quite uncommon and generally presents with GI bleeding, abdominal pain, and obstruction. However, presentation of CLL as discrete masses without GI symptoms is very rare. A notable complication for patients with CLL is infection due to immunological dysregulation and is typically caused by encapsulated bacteria involving the respiratory tract while viral infections often happen post treatment. Here we present a 78-years-old female with history of treatment-naïve CLL who was incidentally found to have discrete colonic masses secondary to CLL, as well as cytomegalovirus (CMV) and herpes simplex virus (HSV) infections during endoscopic studies for colostomy reversal. On follow-up computed tomography, she was found to have pulmonary amyloidosis as well. We recommend that gastrointestinal tract evaluation should be a part of the complete assessment of the treatment response and remission status in CLL patients to permit early and appropriate therapeutic intervention.