The Clinical& Radiological Respiratory Features in Acute Leukemia At Presentation: A Descriptive Study of 118 Iraqi Adult Patients


ABSTRACT:BACKGROUND:Acute leukemia is a hematological malignancy characterized by an uncontrolled proliferation ofhemopietic primitive cells. Presenting features of acute leukemia include fever, anemia, pallor;hepatosplenomegaly &lymphadenopathy, bleeding tendency, bone pain&gum hypertrophy.Intrathoracic manifestations of acute leukemia include infection,mediastinal widening , hemorrhage,infiltration, embolism, edema, pericarditis &acute respiratory distress syndrome.OBJECTIVE:To describe the clinical &radiological respiratory features of acute leukemia at presentation,beforestarting chemotherapy.PATIENTS AND METHODS:Patients with acute leukemia of age ranged from 15-75 years were incorporated in this study, patientswere excluded from the study if they had previous malignancy, lung disease, or if received cytotoxictreatment. Every patient had a detailed history of pulmonary symptoms & chest examination,chest xrayexamination, sputum samples & pleural aspirates for relevant patients.RESULTS:Of 118 patients with actue leukemia at presentation, 60% of patients were males& 40% werefemales. Respiratory symptoms including cough,dyspnea&chest pain were found in27.7% of patients(cough 24.4% ,dyspnea 2.5%,chest pain 0.8%) . Respiratory signs including crepitations ,decreasedair entry & bronchial breathing were found in 12.5% of patients(crepitation 3.3%, decreased air entryin 6.7%, bronchial breathing in 2.5%). Chest X-ray abnormalities were found in 14.3% of patients,these include mediastinal widening in 5.9% of patients .Pleural effusion in 4.2% & parenchymalinfiltrates in 4.2% of patientsCONCLUSION:The chest findings in patient with actue leukemia at presentation were not uncommon. mediastinalwidening was the commonest, pleural effusion&parenchymal infiltrates were less common findings