Vaid Ashok K, Batra Sandeep, Karanth Suman S, Gupta Sachin
Department of Medical Oncology, Medanta, The Medicity, Gurgaon, Haryana, India.
Department of Medical Oncology, Max Superspeciality Hospital, Mohali, Punjab, India.
Avicenna J Med. 2015 Oct-Dec;5(4):131-3. doi: 10.4103/2231-0770.165125.
We present a rare case of acute promyelocytic leukemia (APL) presenting as pulmonary thromboembolism being misdiagnosed as community-acquired pneumonia. Thrombotic phenomenon in APL are poorly understood and grossly underreported. In our case, following no response to standard antibiotic treatment, the patient was further investigated and detected to have an acute pulmonary thromboembolism following right lower limb deep vein thrombosis (DVT). Though, complete blood picture revealed only mild hyperleukocytosis, bone marrow biopsy and aspiration revealed 60% blasts and a positive t (15,17)(q22,12) and PML retinoic acid receptor alpha (RARA) fusion protein on molecular cytogenetics. He was diagnosed as APL and received treatment with all-transretinoic acid (ATRA) and arsenic trioxide (ATO) and therapeutic anticoagulation.
我们报告了一例罕见的急性早幼粒细胞白血病（APL），该病例最初表现为肺血栓栓塞，被误诊为社区获得性肺炎。APL中的血栓形成现象目前了解甚少，且严重报告不足。在我们的病例中，患者在接受标准抗生素治疗无效后，进一步检查发现右下肢深静脉血栓形成（DVT）后出现急性肺血栓栓塞。虽然全血细胞计数仅显示轻度白细胞增多，但骨髓活检和穿刺显示60%的原始细胞，分子细胞遗传学检测显示t（15,17）（q22,12）阳性和早幼粒细胞白血病视黄酸受体α（RARA）融合蛋白阳性。他被诊断为APL，并接受了全反式维甲酸（ATRA）、三氧化二砷（ATO）治疗及治疗性抗凝。
