Leukemic Infiltration
Epidemiology
Etiology
Physiology
- Leukemic cells directly infiltrating into the alveoli and interstitial
Diagnosis
- FOB
- BAL: may demonstrate leukemic cells
- TBB: may demonstrate leukemic cells, but is usually not necessary
- CXR/Chest CT Patterns
- Focal or Multi-Focal Infiltrates:
- In contrast, hyperleukocytic syndrome (pulmonary leukostasis) typically presents with diffuse infiltrates
- Exudative Pleural Effusion: can occur in association with leukemic infiltrates
- Effusions contain leukemic cells
Clinical
- Characteristically presents as persistence of infiltrates, in the absence of identified infection, and despite appropriate antibiotic therapy
- Dyspnea:
- Hypoxemia:
- Cough:
- Pleuritic Chest Pain:
- Tachypnea:
Treatment
- Supportive Management:
- Ventilatory support, treatment of concomitant infection, etc
Treatment of Underlying Leukemia:
- It is not clear if pulmonary leukemic infiltration indicates a need for more intensive induction or consolidation chemotherapy
References
