SYMPTOMATIC LEUKEMIC INFILTRATION OF THE LUNG AS COMPLICATION OF ACUTE MYELOID-LEUKEMIA

History: A 70-year-old woman was admitted with the suspected diagnosis of acute leukaemia. She had complained of decreased physical capacity , nonproductive cough and dyspnoea. Investigations: The blood picture showed leukocytosis of 46/nl, anaemia (haemoglobin 8.8 g/dl) and throm bocytopenia (25 platelets/nl). Differential white count: 10 % blast ce lls, 43 % monocytes. Bone marrow smear revealed acute monocytic leukae mia. The chest radiogram showed increased interstitial markings and lu ng function tests indicated moderate restriction. Treatment and course : The atypical pneumonia was treated with erythromycin, but the respir atory functions deteriorated Further within 2 days. Cytostatic treatme nt had been started on the second hospital day, but the patient died a few hours later in respiratory failure. Autopsy revealed numerous alv eolar infiltrates by immature myeloid cells. Conclusion: in patients w ith acute leukaemia and respiratory symptoms, pulmonary involvement sh ould be included in the differential diagnosis and, if present, chemot herapy immediately begun.