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Extramedullary leukemia in children presenting with proptosis
Ramesh Murthy1, Geeta K Vemuganti, Santosh G Honavar
1Ocular Pathology, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India. drrameshmurthy@gmail.com
Journal of Hematology & Oncology
|January 27, 2009
Summary
Orbital manifestations of acute myeloid leukemia (AML) are highlighted. A peripheral blood smear is crucial for diagnosing AML in patients with sudden proptosis or orbital mass, often complemented by bone marrow biopsy.
Area of Science:
- Ophthalmology
- Hematology
- Oncology
Background:
- Acute myeloid leukemia (AML) can present with orbital manifestations.
- Orbital signs may be the initial presentation of AML.
- Early diagnosis is critical for effective treatment.
Purpose of the Study:
- To highlight orbital manifestations of AML.
- To emphasize the diagnostic role of peripheral blood smear in AML.
- To evaluate the utility of orbital biopsy and blood smear in diagnosing AML.
Main Methods:
- Retrospective review of 12 patients with proptosis diagnosed with AML.
- Analysis of clinical presentation, orbital findings, and diagnostic methods.
- Correlation of orbital disease with AML diagnosis.
Main Results:
- Median age of presentation was 6 years; male:female ratio was 0.7:1.
- Proptosis was present in all patients; orbital mass in 41.7%.
- Peripheral blood smear alone diagnosed AML in 8 patients; biopsy confirmed in 4.
Conclusions:
- Peripheral blood smear is vital for sudden proptosis/orbital mass in children/young adults.
- Orbital biopsy should be considered alongside blood smear.
- Bone marrow biopsy complements diagnosis in aleukemic leukemia or inconclusive smears.
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