PULMONARY SEQUESTRATION IN A CHILD WITH ACUTE MYELOID-LEUKEMIA

The article describes a relatively rare congenital anomaly that was di fficult to diagnose in a 10-year-old child with acute nonlymphoblastic leukemia. Just at diagnosis of leukemia, the patient showed a patholo gic chest radiograph because of a parenchymal thickening at the right lung apex. The presence of bronchopneumonia was suspected, and broad-s pectrum antibiotic therapy was started with subsequent antifungal trea tment for persistent fever and concurrent chemotherapy-induced marrow aplasia, which did not favor pulmonary infiltrate recovery. Continuous culture tests, including bronchial swab, proved negative for Koch-Wee ks bacillus, fungal organisms, and other pathogens. Computed tomograph y, however, was suggestive of Aspergillus lung involvement, and apical segmentectomy was performed. The anatomic pathologist suggested the d iagnosis of intralobar sequestration. In summary, when pulmonary patho logy with an excavation is found in a leukemic child, one must conside r the possibility of pulmonary sequestration complicated by an infecti ous disease.