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Leukemic cellular thrombi in pulmonary blood vessels. Subleukemic myelogenous leukemia following chloramphenicol‐induced aplastic anemia
Author(s) -
Meyer John S.,
Boxer Michael
Publication year - 1973
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197309)32:3<712::aid-cncr2820320325>3.0.co;2-h
Subject(s) - medicine , disseminated intravascular coagulation , pathology , aplastic anemia , leukemia , autopsy , sepsis , histiocyte , bone marrow , immunology
After an 8‐year period of aplastic anemia following chloramphenicol therapy, a 39‐year‐old woman developed subleukemic acute myelogenous leukemia, and she died with Pseudomonas sepsis 18 months later. Autopsy demonstrated leukemic cellular thrombi that partially or completely occluded many small pulmonary arteries, arterioles, and small veins. Scattered among the leukemic cells in the thrombi were hemosiderotic histiocytes reflecting transfusional hemosiderosis. The staining characteristics, esterase activity, and electron microscopic appearances of the cellular thrombi confirmed their myeloid leukemic nature. The leukemic cells were cemented together by fibrin. We propose that the leukemic cells produced procoagulants that initiated coagulation on their surfaces, and that the leukemic thrombi are the morphological counterpart of a local accelerated intravascular coagulopathy. The possible clinical significance of pulmonary leukemic thrombi is discussed.