Pulmonary Leukemic Infiltration in Relapsed Acute Myeloid Leukemia: A Case Report.

Area of Science:

• Hematology
• Oncology
• Pulmonary Medicine

Background:

• Pulmonary leukemic infiltration (PLI) is an uncommon manifestation of acute myeloid leukemia (AML).
• PLI is frequently misdiagnosed as infectious pneumonia, delaying appropriate treatment.
• Diagnosis can be challenging, particularly in relapsed AML without hyperleukocytosis.

Purpose of the Study:

• To report a unique case of pulmonary leukemic infiltration in a relapsed AML patient.
• To emphasize the importance of a high index of suspicion for PLI in atypical presentations.
• To illustrate the efficacy of salvage chemotherapy and stem cell transplantation in managing PLI.

Main Methods:

• Case report of a relapsed AML patient.
• Clinical presentation, diagnostic workup, and treatment course are described.
• Response to salvage chemotherapy and subsequent stem cell transplantation was evaluated.

Main Results:

• The patient presented with pulmonary infiltrates suggestive of pneumonia but confirmed as leukemic infiltration.
• The patient had relapsed AML without hyperleukocytosis, complicating the initial diagnosis.
• Aggressive salvage chemotherapy followed by allogeneic stem cell transplantation led to resolution of pulmonary infiltration and complete remission.

Conclusions:

• Pulmonary leukemic infiltration requires a high index of suspicion, especially in relapsed AML.
• Prompt diagnosis and aggressive treatment, including salvage chemotherapy and stem cell transplantation, can be effective.
• This case underscores the potential for successful management of challenging PLI cases.