[Acute myeloid leukemia with pulmonary manifestation].
BACKGROUND
Extramedullary manifestations of leukemias are often misinterpreted. The prognosis of pulmonary manifested leukemias is poor.


METHODS
A 57-year-old female patient was admitted to our hospital because of refractory pneumonia and the suspicion of acute leukemia. The diagnosis of acute myeloid leukemia (AML, FAB M5a) was derived from bone marrow aspiration. The radiograph and the computed tomography of the chest showed infiltrations of both lungs. The cytologic aspect of a bronchoalveolar lavage was dominated by leukemic blasts, therefore AML with pulmonary manifestation was diagnosed. Cytotoxic therapy with cytarabine/idarubicin was combined with prednisolone. In the course of treatment the pulmonary function improved and radiographic alterations diminished significantly. After induction therapy complete haematological remission (CR) was shown by bone marrow aspiration. Two consolidation therapies followed. Unfortunately, the patient died four months after CR in a local hospital.


CONCLUSIONS
The pulmonary manifestation of AML can be diagnosed by bronchoscopy. In contrast to the literature the initial course of the disease in this case was favourable possibly due to the addition of prednisolone to the cytotoxic treatment.
Schalk
E
E
Klinik für Hämatologie/Onkologie, Otto-von-Guericke-Universität Magdeburg.
Franke
A
A
Koenigsmann
M
M
D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000188:drug therapy; D008171:Lung Diseases / Q000209:etiology*; D008875:Middle Aged