Pleural effusion as the presenting feature in chronic myeloid leukemia

Abstract

Pleural effusion is rarely associated with chronic myeloid leukemia (CML). CML is asymptomatic and incidentally detected in majority of the patients. Few present with symptoms related to splenomegaly. Pleural effusion as the presenting symptom in CML has rarely been reported in the literature. We report the case of 58-year-old woman who presented with pleural effusion. Working diagnosis was lung malignancy or lymphoma. However, investigations and examination revealed CML in blast crisis. The patient was then treated with dasatinib, and she responded well. The exact mechanism for pleural effusion in CML is not known. It could be due to leukemia infiltration, extramedullary hematopoiesis, capillary obstruction, infections, or drug induced. Our case showed features compatible with extramedullary hematopoiesis. CML can rarely present with pleural effusion. Simple tests such as blood smear examination and pleural fluid cytology will aid in the diagnosis. The physicians and pathologists should be aware of this association.

Keywords

• bcr–abl
• blast
• chronic myeloid leukemia
• cytology
• hematology