Abstract
A resected case of pulmonary atypical mycobacterial disease associated with acute myeloid leukemia with severe neutropenia is reported. A 55-year-old man was admitted because of acute myeloid leukemia. An abnormal shadow on chest X-ray was pointed out. The definite diagnosis did not be achieved by a bronchoscopy. By chest CT findings, the diagnosis of lung cancer or infectious disease such as pulmonary tuberculosis, pulmonary mycosis was suspected. Because a treatment of leukemia should be started as soon as possible, an operation was performed. The diagnosis of pulmonary atypical mycobacterial disease was made by an operative needle aspiration examination and segmentectomy of the left upper division was performed. In preoperative blood examination, white blood cell counts were 1460/μl, neutrophil counts were 226/μl, neutropenia were severe. We did not use G-CSF because it may promote the proliferation of blast cells. As an antimicrobial prophylaxis, panipenem betamipron and amikacin sulfate were administered according to IDSA guideline for febrile neutropenia. Postoperative course was uneventful and he had no complications such as postoperative pneumonia or wound dehiscence. It might be thought that a neutropenia did not always disturb an enforcement of pulmonary resection.
