A 21 year old, male patient came to the hospital because of dyspnea as chief complaint. Chest roentgenography revealed an enlarged cardiac shade and pleurisy in the right chest, and he was immediately hospitalized. Examination in detail showed that the leukocyte count was 10, 600, and the myeloblas was 80% in the peripheral blood, and puncture of the spinal cord revealed that myeloblast was 92.6%.A diagnosis of acute myeloleukmia was established. Because puncture of the thoracic cavity detected many leukemic cells which were identical in propperty with peripheral myeloblasts, antileukemic agents were administered by both the systemic route and the local inf uson into the thoracic cavity, but proved not markedly effective. On the 9 th day of hospitalization, the patient died of cardiac failure. In autopsy, marked leukemic cell infiltrations were observed in the pleura and pericardium. Although complication of leukemia by pleurisy has frequently been reported, yet because such a case where the cardiopulmonary symptoms remain in the foreground throughout the course, with pericarditis and pleurisy as incipient symptoms, e.g., the patient presented herein, is rare and interesting, the findings in this patient are presented in the foregoing.
