Pulmonary leukostasis: Role of perfusion lung scan in diagnosis and followup

A patient with hyperleukocytic myelomonocytic leukemia who presented to the emergency room with sudden pleuritic chest pain and dyspnea is reported. C linical manifestations included dyspnea tachypnea and hyperventilation. Blo od gas analysis revealed hypoxemia, hypocarbia, and respiratory alkalosis, Chest X ray was normal, and perfusion lung scan revealed a diffuse vascular occlusive pattern compatible with pulmonary leukostasis, The patient under went immediate leukapheresis with subsequent mitigation of symptoms. A seco nd perfusion lung scan showed evidence of significant improvement. To our k nowledge this is the first published case of hyperleukocytosis presenting w ith pulmonary leukostasis that was successfully diagnosed and followed by s erial perfusion lung scan. Am. J. Hematol, 67:136-138, 2001, (C) 2001 Wiley -Liss, Inc.