title: Acute promyelocytic leukemia presenting as pulmonary thromboembolism: Not all APLs bleed.
abstract: We present a rare case of acute promyelocytic leukemia (APL) presenting as pulmonary thromboembolism being misdiagnosed as community-acquired pneumonia. Thrombotic phenomenon in APL are poorly understood and grossly underreported. In our case, following no response to standard antibiotic treatment, the patient was further investigated and detected to have an acute pulmonary thromboembolism following right lower limb deep vein thrombosis (DVT). Though, complete blood picture revealed only mild hyperleukocytosis, bone marrow biopsy and aspiration revealed 60% blasts and a positive t (15,17)(q22,12) and PML retinoic acid receptor alpha (RARA) fusion protein on molecular cytogenetics. He was diagnosed as APL and received treatment with all-transretinoic acid (ATRA) and arsenic trioxide (ATO) and therapeutic anticoagulation.
authors.affiliation: Department of Medical Oncology, Medanta, The Medicity, Gurgaon, Haryana, India.
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Vaid
authors.affiliation: Department of Medical Oncology, Medanta, The Medicity, Gurgaon, Haryana, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Batra
authors.affiliation: Department of Medical Oncology, Medanta, The Medicity, Gurgaon, Haryana, India.
authors.forename: Suman S
authors.initials: SS
authors.lastname: Karanth
authors.affiliation: Department of Medical Oncology, Max Superspeciality Hospital, Mohali, Punjab, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Gupta
keywords: Acute promyelocytic leukemia; community-acquired pneumonia; pulmonary thromboembolism