Leukemic infiltration of the esophagus.
BACKGROUND
Leukemic infiltrates of the esophagus have been described occasionally in autopsy series, but there are no reports of antemortem diagnosis.


METHODS
Case reports are presented for three patients with acute myeloid leukemia in whom leukemic infiltration of the esophageal mucosa was diagnosed histologically and cytologically by endoscopic examination. Autopsies of patients with leukemia from 1976-1988 were reviewed.


RESULTS
The autopsy review of 207 patients with leukemia showed evidence of leukemic infiltration in the esophagus in 7.2% of cases. The only clinical factor identified to be significantly associated with esophageal involvement by leukemic cells was a high initial leukocyte count. Esophageal involvement was associated with leukemic infiltration of other soft tissues and organs.


CONCLUSIONS
Although the etiology of dysphagia in patients with acute leukemia is usually related to infection, reflux, chemotherapy toxicity, or benign strictures, the frequency of esophageal leukemic infiltration in this autopsy series suggests that this diagnosis must be considered. Esophageal leukemia is usually associated with widely disseminated soft tissue and visceral infiltrates.
Fulp
S R
SR
Department of Internal Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157-1082.
Nestok
B R
BR
Powell
B L
BL
Evans
J K
JK
Geisinger
K R
KR
Gilliam
J H
JH
D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000473:pathology*; D015479:Leukemia, Myelomonocytic, Acute / Q000473:pathology*; D017254:Leukemic Infiltration; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies