Endobronchial Granulocytic Sarcoma Causing Acute Respiratory Failure in Acute Myelogenous Leukemia

Abstract

Infiltration by leukemic cells may occur in many organs. When localized masses caused by myeloid leukemic infiltration occur, they are called granulocytic sarcomas. Such tumors may be mistaken for primary carcinomas. In this report, we describe a 63-yr-old man with acute myelogenous leukemia who developed progressive atelectasis of the left lower lobe of the lung. Bronchoscopy revealed a fungating endobronchial tumor completely obstructing the left lower lobe bronchus and partially occluding the left upper lobe bronchus. Biopsies from this lesion showed an endobronchial granulocytic sarcoma. Despite chemotherapy, the patient developed progressive hypoxemia and died.

Intrathoracic Myeloid Sarcoma

“…4 Endobronchial myelocytic sarcoma causing acute respiratory failure in acute myelogenous leukemia is rare. 5 The incidence of myelocytic sarcoma is reported to be 2.9% in leukemic patients in a small case series. 6 The incidence varies from 3.1% to 7.0% in various autopsy series.…”

“…A literature search revealed 27 other reported cases of intrathoracic myelocytic sarcomas, with 6 cases causing superior vena cava syndrome 4,5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] (Table 1). Of the 28 reported cases, 13 patients (46%) responded to treatment, 11 (39%) died, 1 patient signed out against medical advice before receiving treatment, and in the other 3, the clinical course was not reported.…”