Abstract: To the Editor:Extra medullary infiltration is often seen in acute myeloid leukemia (AML).Many take the form of tumor masses as myeloid sarcoma.However,leukemic cell infiltration of the appendix is rare.Herein,we report a case of AML initially presented as acute nonsuppurative appendicitis due to leukemic cell infiltration which is a rarer manifestation of de novo AML.