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Concurrent chronic myelogenous leukemia and tuberculous lymphadenitis: a case report
Nirupma Panikar1, Meera Sikka, Navjeevan Singh
1Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India. nirupmapanikar@rediffmail.com
Acta Cytologica
|February 3, 2006
Summary
In immunocompromised patients, simultaneous conditions like extramedullary hematopoiesis and infection can occur. Cytologic findings may indicate hematologic disorders and prompt a search for concurrent infectious diseases.
Area of Science:
- Hematopathology
- Infectious Diseases
- Cytopathology
Background:
- Double pathology is rare, necessitating a comprehensive diagnostic approach to identify a single cause.
- Exceptions are noted, particularly in immunocompromised individuals with multiple co-existing conditions.
- Infectious disorders are a common cause of diagnostic challenges in immunocompromised patients.
Observation:
- Fine needle aspiration of lymph nodes in a 22-year-old male revealed two distinct pathologies.
- One lymph node demonstrated extramedullary hematopoiesis.
- The second lymph node showed acellular necrosis with acid-fast bacilli.
Findings:
- Hematologic workup confirmed chronic myelogenous leukemia (CML).
- Extramedullary hematopoiesis was identified as a cytologic indicator of underlying hematologic disorders.
- The presence of acid-fast bacilli suggested a concurrent infectious process.
Implications:
- Extramedullary hematopoiesis can serve as a cytologic clue for diagnosing hematologic malignancies like CML.
- The case highlights the importance of considering and investigating for additional infectious diseases, even when a primary hematologic disorder is identified.
- This underscores the complexity of diagnosing co-existing conditions in immunocompromised patients.
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