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Published on: February 21, 2018
A rare case of PDGFRA-positive chronic eosinophilic leukemia
Kalpana Bothale1, Akanksha Salkar2, Amit Salkar3
1Department of Pathology, NKP Salve Institute of Medical Sciences and Research Center, Nagpur, Maharashtra, India.
Insights
This case report details a rare instance of Chronic Eosinophilic Leukemia (CEL) in a 49-year-old male. The patient presented with multiorgan damage, highlighting the diagnostic challenges and rare clinical manifestations of CEL.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Chronic eosinophilic leukemia (CEL) is a rare clonal disorder characterized by excessive eosinophil production.
- CEL shares overlapping features with idiopathic hypereosinophilic syndrome (IHES), complicating diagnosis.
- Multiorgan involvement, particularly cardiac and neurological, is an uncommon presentation of CEL.
Purpose of the Study:
- To report a rare case of Chronic Eosinophilic Leukemia (CEL) with multiorgan damage.
- To emphasize the diagnostic challenges associated with CEL.
- To highlight the unusual clinical manifestations of CEL, including cardiac and neurological involvement.
Main Methods:
- Case report of a 49-year-old male patient.
- Analysis of peripheral blood smear findings, including eosinophil counts, morphology, and blast percentage.
- Examination of bone marrow biopsy for cellularity, lineage proliferation, and blast percentage.
Main Results:
- Peripheral blood smear showed predominantly eosinophils with dysplastic changes, left shift, and 2% blasts.
- Bone marrow examination revealed 5% blasts, increased eosinophils and their precursors, and myeloid/megakaryocytic proliferation.
- The patient presented with significant multiorgan damage.
Conclusions:
- Chronic Eosinophilic Leukemia (CEL) is a rare hematologic malignancy.
- The overlapping clinical and pathological features of CEL and IHES present diagnostic difficulties.
- This case underscores the rarity of CEL presenting with severe cardiac and neurological manifestations.
Abstract:
Chronic eosinophilic leukemia (CEL) is a clonal proliferation of eosinophilic precursors resulting in a persistently elevated number of eosinophils in blood, bone marrow, and peripheral tissues. The vaguely overlapping clinicopathological picture of CEL with idiopathic hypereosinophilic syndrome (IHES) often adds to the diagnostic dilemma. Here, we report a rare case of 49-year-old male who presented with multiorgan damage. Peripheral blood smear revealed predominantly eosinophils with dysplastic changes, shift to left in eosinophilic series, and 2% blasts. The bone marrow showed 5% blasts and many eosinophils, precursors of eosinophils, and myeloid and megakaryocytic proliferation. Till date, CEL is a very rare entity. Its presentation with cardiac and neurological manifestations is still rare.
