title: Leukemic infiltration of the lung following allogeneic hematopoietic stem cell transplantation.
abstract: Pulmonary leukemic infiltration (PLI) is more common than generally recognized, but accurate antemortem diagnosis with pathological proof is rarely achieved. We describe herein the clinical courses of two patients with PLI following hematopoietic stem cell transplantation (HSCT). One case is a male patient with acute biphenotypic leukemia, and the other is a female patient with myelodysplastic syndrome. In both cases, hyperleukocytosis did not proceed to PLI. Moreover, the former case presented PLI as the initial manifestation of relapsed leukemia and the latter was accompanied with the fungal pneumonia. High-resolution computed tomography (HRCT) of the chest at onset of PLI showed diffuse small nodular lesions along peribronchovascular bundle, and diagnosis of leukemic infiltration was made based on pathological findings obtained from transbronchial lung biopsy. Biopsy specimens further revealed leukemic infiltration along the lymphatic surrounding the peribronchial or perivascluar regions, which corresponded well with HRCT findings. Thus, radiological and pathological corroborating assessment was important to reach the correct diagnosis.
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kakihana
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. k.ohashi@cick.jp.
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: Radiology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Japan.
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Sakai
authors.affiliation: Radiology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kamata
authors.affiliation: Respiratory Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hosomi
authors.affiliation: Pharmacy Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Nishiwaki
authors.affiliation: Pharmacy Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Yokoyama
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Akiyama
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
mesh_terms: D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007938:Leukemia / Q000473:pathology; D017254:Leukemic Infiltration / Q000175:diagnosis* / Q000209:etiology; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000209:etiology; D009894:Opportunistic Infections; D014184:Transplantation, Homologous