Iizuka Hiroko, Mori Yosuke, Fukuda Yasutaka, Iwao Noriaki, Koike Michiaki, Noguchi Masaaki
Department of Hematology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
Department of Hematology, Juntendo University Urayasu Hospital, Chiba, Japan.
Leuk Res Rep. 2021 Sep 24;16:100269. doi: 10.1016/j.lrr.2021.100269. eCollection 2021.
Although a previous autopsy series demonstrated that pulmonary leukemic infiltration (PLI) is a major pulmonary complication in patients with acute myeloid leukemia (AML), an antemortem diagnosis of PLI is rare. Diverse pulmonary complications cause acute respiratory failure (ARF) in patients with AML undergoing chemotherapy. This article reports two elderly patients with AML who presented with ARF due to PLI mimicking severe pneumonia during induction chemotherapy. Accurate antemortem diagnosis of PLI was almost impossible without pathological examination since the clinical course was not typical of PLI. We recommend considering PLI in patients with AML who have an unknown etiology of ARF.
尽管先前的尸检系列研究表明，肺部白血病浸润（PLI）是急性髓系白血病（AML）患者的主要肺部并发症，但生前诊断PLI却很罕见。多种肺部并发症可导致接受化疗的AML患者发生急性呼吸衰竭（ARF）。本文报告了两名老年AML患者，他们在诱导化疗期间因PLI酷似重症肺炎而出现ARF。由于临床病程并非PLI的典型表现，若无病理检查，几乎不可能在生前准确诊断PLI。我们建议，对于ARF病因不明的AML患者，应考虑PLI的可能。
