Bulky lymphadenopathy in acute myeloid leukemia |
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Authors: | S Sica P Salutari G d'Onofrio G Zini L Laurenti F Sora' G Leone |
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Institution: | (1) Institute of Medical Semiology, Department of Hematology, Università Cattolica "Sacro Cuore", Largo Agostino Gemelli, 8, I-00168 Rome, Italy, IT |
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Abstract: | Two cases of acute myeloid leukemia (AML) presenting with bulky adenopathy are reported. Both patients were febrile at admission
and showed massive and diffuse lymph node involvement, hepatomegaly, and splenomegaly. Erythematopapular leukemic skin lesions
were present in one case at the onset and developed in the other at the time of relapse. Anemia, thrombocytopenia, and moderate
leukocytosis were present in both. The presence of immature cells in peripheral blood and bone marrow allowed a rapid diagnosis
of AML, FAB M1, in one patient. In the other case, owing to the paucity of immature cells in peripheral blood and bone marrow,
lymph node biopsy with histology, imprint cytology, and immunocytochemistry were essential for the diagnosis (AML, FAB M2,
with trilineage dysplasia and basophilic involvement). Both patients achieved complete remission (CR), followed by an early
relapse 3 months later. They underwent allogeneic bone marrow transplantation (BMT) from HLA identical siblings. One patient
is actually alive and in CR at 6 months after BMT; the other patient showed a leukemic regrowth after transplantation and
died 4 months later.
Received: December 8, 1997 / Accepted: April 29, 1998 |
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Keywords: | Bulky lymphadenopathy Acute myeloid leukemia Diagnosis |
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