Leukemia (thoracic manifestations)

Thoracic manifestations of leukemia can be divided into those related to the disease itself and those associated with its treatment. Leukaemias are hematologic malignancies in which occur a proliferation of hematopoietic cells at an undifferentiated or partially differentiated stage of maturation.

Direct involvement
  • lymphadenopathy
    • the most frequent manifestation of leukemia in the thorax
    • commonly seen in lymphoid leukaemias
    • axillary lymphadenopathy is more common in CLL (~48%)
  • pulmonary leukemic infiltrates
    • extravascular collections of leukemic cells in the lung parenchyma
    • found in about a quarter of patients in autopsy studies
    • overall similar distribution among the four major types of leukemia
  • pulmonary leukostasis
    • over-accumulation of leukemic cells within the small vessels leading to obstruction
    • it is a medical emergency that presents clinically with acute respiratory failure
  • pleural leukemic infiltrates 
    • seen in up to a fifth of cases in autopsies series
    • commonly seen in advanced stages of chronic leukaemias 
    • on imaging, presents as pleural effusion and or soft tissue pleural thickening
  • heart involvement 
    • present in about 25% of cases in autopsies series
    • usually asymptomatic 
    • can potentially involve the pericardium, the myocardium, and the endocardium 
  • myeloid sarcoma
    • although the thorax is uncommonly involved, it may occur in the lungs, pleura, mediastinum, chest wall, and breast
    • the mediastinum is the most common site of myeloid sarcoma in the chest
  • thoracic cage
  • associations: some conditions affecting the chest, although without having a clear mechanism of connection, have been reported to occur in patients with leukemia
Treatment-related complications

See also

Siehe auch:
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