抄録
A case of AML with leukemic pleuritis as an initial manifestation and with leukemia cutis and meningeal leukemia as later complication was reported.
A 40-year-old male was admitted to our hospital on September 13, 1980 because of dyspnea and cough. Peripheral blood showed RBC 436×104/cmm, Hb 12.7 g/dl, plt 40.7×104/cmm and WBC 5,400/cmm with normal differential. A sternal bone marrow aspiration revealed N.C.C. 23.2×104/cmm with 52.6% leukemic cell. From positive peroxidase and chloroacetate esterase staining, the diagnosis of AML was made. The chest X-ray showed the bilateral pleural effusion and hillar lymph node swelling. The efftusion was exudative and contained many leukemic cells. A complete hematologic remission was achieved by DCVP therapy. Lymph node swelling and pleural effusion disappeared by successive two courses of consolidation therapy.
On Febrtary 23, 1981, the patient relapsed with leukemia cutis. At the end of March, the patient developed diplopia due to lt-abducens paralysis and was treated with four intrathecal injection of Ara-C, MTX and Pred. But remission was not reinduced in spite of intensive treatment. The leukemia cutis aggravated and the patient died of intracerebral hemorrhage in nine months survival.
