[Symptomatic leukemic infiltration of the lung in acute myeloid leukemia].

HISTORY: A 70-year-old woman was admitted with the suspected diagnosis of acute leukaemia. She had complained of decreased physical capacity, nonproductive cough and dyspnoea.

INVESTIGATIONS: The blood picture showed leukocytosis of 46/nl, anaemia (haemoglobin 8.8 g/dl) and thrombocytopenia (25 platelets/nl). Differential white count: 10% blast cells, 43% monocytes. Bone marrow smear revealed acute monocytic leukaemia. The chest radiogram showed increased interstitial markings and lung function tests indicated moderate restriction.

TREATMENT AND COURSE: The atypical pneumonia was treated with erythromycin, but the respiratory functions deteriorated further within 2 days. Cytostatic treatment had been started on the second hospital day, but the patient died a few hours later in respiratory failure. Autopsy revealed numerous alveolar infiltrates by immature myeloid cells.

CONCLUSION

In patients with acute leukaemia and respiratory symptoms, pulmonary involvement should be included in the differential diagnosis and, if present, chemotherapy immediately begun.