Leukemic pulmonary infiltration diagnosed by sputum Giemsa-staining

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  • OSAKI Masahide
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • LEE Yoonha
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • OSAMURA Yoko
    Division of Laboratory, Japanese Red Cross Nagoya First Hospital
  • ICHIKI Tomoe
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • OKABE Motohito
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • KAWAGUCHI Yuka
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • OBIKI Marie
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • ITO Ai
    Department of Pathology, Japanese Red Cross Nagoya First Hospital
  • GOTO Miyo
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • ARAIE Hiroaki
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • GOTO Tatsunori
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • MORISHITA Takanobu
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • OZAWA Yukiyasu
    Department of Hematology, Japanese Red Cross Nagoya First Hospital
  • ITO Masafumi
    Department of Pathology, Japanese Red Cross Nagoya First Hospital
  • MIYAMURA Koichi
    Department of Hematology, Japanese Red Cross Nagoya First Hospital

Bibliographic Information

Other Title
  • 喀痰のGiemsa染色で診断された白血病肺浸潤
  • 症例報告 喀痰のGiemsa染色で診断された白血病肺浸潤
  • ショウレイ ホウコク カクタン ノ Giemsa センショク デ シンダン サレタ ハッケツビョウ ハイ シンジュン

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Abstract

<p>A 54-year-old man with acute myeloid leukemia (AML) underwent allogeneic bone marrow transplantation from a human leukocyte antigen-matched unrelated donor in nonremission status. Bone marrow aspiration performed on day 14 showed that the patient had achieved complete remission; however, he relapsed on day 28. The patient developed a wet cough, and chest computed tomography performed on day 27 revealed pneumonia. Because pneumonia developed along with the leukemic relapse, we suspected that it was due to pulmonary leukemic infiltration (PLI). Giemsa-stained sputum showed some blast cells and fluorescence in situ hybridization indicated that the patient had monosomy 7, which was also detected in bone marrow blasts. Though we prescribed hydroxycarbamide and decreased tacrolimus rapidly, AML progressed and led to the patient's death on day 45. Histopathological findings of the autopsy performed the next day showed diffuse alveolar damage in both lungs. The blast cells were packed in blood vessels of alveolar septa and were also seen in alveoli. PLI was diagnosed pathologically. In conclusion, our case demonstrates that Giemsa stain of sputum is useful in quick diagnosis of PLI without invasive examination.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 61 (3), 257-261, 2020

    The Japanese Society of Hematology

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