Çalışkan Kamış Şule
Adana Faculty of Medicine, Adana City Training and Research Hospital, Pediatric Hematology and Oncology Clinic, University of Health Sciences, Adana, Turkey.
Case Rep Hematol. 2025 May 20;2025:9949125. doi: 10.1155/crh/9949125. eCollection 2025.
This case report describes a 17-year-old female patient who initially presented with vaginal bleeding, weight loss, and nonspecific symptoms, which led to the diagnosis of B-cell acute lymphoblastic leukemia (B-ALL). This unusual presentation highlights the importance of considering hematological malignancies in patients with atypical symptoms. The patient, married for 2 weeks, experienced vaginal bleeding following her first sexual intercourse, which did not resolve spontaneously. She also reported a 6 kg weight loss over the past 3-4 months, hair loss, and a history of dysmenorrhea and an ovarian cyst detected 2 years prior. Laboratory investigations revealed leukocytosis (WBC: 16,500/μL), anemia (Hb: 11.4 g/dL), and thrombocytopenia (Plt: 44,000/μL). Bone marrow aspiration (BMA) and flow cytometry confirmed the diagnosis of B-ALL, revealing a high percentage of atypical lymphoid cells. This case underscores the rarity of diagnosing hematological malignancies in patients with vaginal bleeding. The patient's symptoms, including weight loss and thrombocytopenia, should have prompted a more comprehensive evaluation. Early recognition of B-ALL is crucial as prompt treatment significantly improves outcomes. The patient was started on prednisolone and alkalinized fluids, and her condition was closely monitored. Vaginal bleeding in young patients should not be dismissed as a minor issue, especially when accompanied by other systemic symptoms like weight loss and thrombocytopenia. Early diagnosis of B-ALL in such cases can lead to better management and prognosis.
本病例报告描述了一名17岁女性患者，她最初出现阴道出血、体重减轻及非特异性症状，最终被诊断为B细胞急性淋巴细胞白血病（B-ALL）。这种不寻常的表现凸显了在有非典型症状的患者中考虑血液系统恶性肿瘤的重要性。该患者结婚两周，首次性交后出现阴道出血，且未自行缓解。她还报告在过去3至4个月内体重减轻了6千克，有脱发情况，并有痛经史，两年前曾检测出卵巢囊肿。实验室检查显示白细胞增多（白细胞计数：16,500/μL）、贫血（血红蛋白：11.4 g/dL）和血小板减少（血小板计数：44,000/μL）。骨髓穿刺（BMA）和流式细胞术确诊为B-ALL，发现大量非典型淋巴细胞。本病例强调了在阴道出血患者中诊断血液系统恶性肿瘤的罕见性。患者的症状，包括体重减轻和血小板减少，本应促使进行更全面的评估。早期识别B-ALL至关重要，因为及时治疗可显著改善预后。患者开始使用泼尼松龙并给予碱化液体，其病情得到密切监测。年轻患者的阴道出血不应被视为小问题，尤其是伴有体重减轻和血小板减少等其他全身症状时。在此类病例中早期诊断B-ALL可实现更好的管理和预后。
