Bilateral Leukemic Pulmonary Infiltrate: A Rare Manifestation of Acute Myeloid Leukemia

Abstract

Acute myeloid leukemia (AML) often presents with nonspecific symptoms of fatigue, anemia or infection. Pulmonary involvement is common in AML during the course of the disease and is usually caused by infection, hemorrhage, leukemic pulmonary infiltrates and leukostasis. Symptomatic leukemic pulmonary infiltrates as a first manifestation of AML is very uncommon but potentially life threatening if not diagnosed and treated in a timely manner. Here we present a rare case of AML with symptomatic bilateral leukemic infiltrates as a first manifestation with peripheral blasts 77%. Common infectious etiologies were ruled out. The pulmonary infiltrates dramatically improved with standard induction chemotherapy. Even though leukemic pulmonary infiltrates in AML is a diagnosis of exclusion but must be considered in the differential diagnosis when a patient present with pulmonary symptoms with blast cell > 40% and suspected acute leukemia. J Med Cases. 2014;5(3):137-139 doi: http://dx.doi.org/10.14740/jmc1651w