Abstract
A 32-year-old male was admitted to the hospital with complaints of fever and lymphadenopathy in March, 1983. Hematological study showed the RBC, 240×104/mm3, platelets, 2.4×104/mm3 and WBC, 127,400/mm3 with 93 percent blastic cells. A bone marrow aspiration showed 91 percent blastic cells. Histochemical studies of leukemic cells supported a diagnosis myelomonocytic leukemia (M4 in FAB classification). He received the two-step treatment of DCMP (daunorubicin, cytarabin, 6-MP and prednisolone), and a complete remission was attained in May, 1983. A relapse occurred in October, 1983, and the DCMP treatment was given again. Twenty days after the beginning of treatment, he suddenly complained of fever, hemoptysis and chest pain. Chest X-ray showed abnormal shadow in the right upper pulmonary lobe. Pulmonary embolism due to mucormyces was suspected. The thrombolytic agents and antifungal agents were administered. Although complete remission was again obtained, the abnormal shadow on chest X-ray remained unchanged. Angiography was done to show pulmonary embolism, and lobectomy of the right upper lobe was performed. Histology of the resected pulmonary lobe showed a thrombosed vessel filled with hyphae of mucormyces.
He is presently well on oral amphotericin B.
