Lung Mass With Crazy‐Paving: An Unusual Initial Presentation of Acute Myeloid Leukaemia

Abstract

ABSTRACT Acute myeloid leukaemia is known to present non‐specifically and more commonly with B symptoms. We report an interesting presentation of acute myeloid leukaemia as a lung mass which initially raised clinical suspicion of primary lung cancer. A gentleman in his 50s who is an active smoker presented with chronic cough, lethargy, and giddiness for 2 months. Physical examination revealed pallor, cervical lymphadenopathy, and bronchial breathing over the right middle zone on auscultation. CT thorax showed a spiculated solid mass with a crazy‐paving pattern, suggestive of lung cancer. However, blood workup showed pancytopenia with a full blood picture showing 60% blast cells. Subsequent bone marrow examination confirmed the diagnosis of AML. The patient received 2‐weekly venetoclax‐based chemotherapy. Serial follow‐up CT showed resolution of lung changes and the patient remained in remission.

Keywords

• acute myeloid leukaemia
• lung cancer
• pulmonary infiltration