RESUMO
Acute promyelocytic leukemia (APL) is identified as the M3 subtype of acute myeloid leukemia (AML). APL is presently one of the most curable leukemias. We describe here a rare case of APL who presented as a relapsed disease after 1 year of chemotherapy for AML. The patient lacked t(15;17) at the initial presentation but was present later at the time of relapse. The patient attained a complete remission following treatment with all-trans retinoic acid (ATRA) and arsenic trioxide-based therapy. We discuss the possible mechanism behind secondary acquisition of promyelocytic leukemia/retinoic acid receptor alpha (PML-RARA) at relapse of AML. We also briefly discuss the clinical features, diagnosis and treatment of APL.
RESUMO
We describe a 50-year-old woman with a history of thyroid cancer who presented with bilateral cervical and submandibular lymphadenopathy, low-grade fevers, and increasing fatigue. The patient underwent lymph node fine-needle aspiration, which showed no evidence of metastatic or lymphoproliferative disease. This procedure was complicated by a parapharyngeal abscess and cellulitis. She was treated unsuccessfully with various courses of antibiotics, but briefly responded to short courses of steroids. As her cervical lymphadenopathy returned, she underwent an excisional lymph node biopsy, which demonstrated caseating granulomatous lymphadenitis. Extensive review of systems, physical examination, laboratory and imaging studies demonstrated no evidence of malignancy, infection or systemic lupus erythematosus . Our patient was clinically diagnosed with Kikuchi-Fujimoto disease and successfully treated with prednisone tapered over 3 months. She remains in clinical remission.
