A Case of Chronic Myelogenous Leukemia Manifested bcr-abl Gene Rearrangement in Pleural Effusion / 대한임상병리학회지

ABSTRACT

Chronic myelogenous leukemia (CML) has been reported to show extra-medullary involvement in 10% of cases and affect mostly lymph nodes and spleen. Extensive pleura involvement of leukemic cells is very rare and no cases of CML infiltrating pleura have been reported in Koreans. Authors recently experienced a case of CML presenting pleural effusion with malignant leukemic cells. A 76-year-old woman was admitted at Inha University Hospital because of dyspnea and rectal bleeding 3 months ago. The patient had a past history of treatment for massive pleural effusion in local clinic 4 month ago. In biochemical test, LD (lactate dehydrogenase) was 620 IU/dL, and serum uric acid was 8.1 ug/dL. Peripheral blood smear showed 3% of blasts and 65% of basophils and bone marrow biopsy revealed marked increase of cellularity. Total cell number of pleural fluid was 14,100/uL and cytological examination of the pleural fluid revealed cells with the morphological features of myeloblasts and occasional megakaryocytes. The bcr-abl gene rearrangement was detected in cells isolated from pleural fluid and bone marrow aspirates. The patient refused treatment with chemotherapeutic for CML and was discharged.