Korean J Hematol.  2009 Jun;44(2):117-121. 10.5045/kjh.2009.44.2.117.

A Case of Acute Biphenotype Leukemia after Diagnosis of Pulmonary Alveolar Proteinosis

• Cheong HR
• Lee HR
• Park SB
• Kim HJ
• Lee NR
• Cheong JH
• Kim MR
• Choi YJ
• Chung JS
• Cho GJ

• KMID: 2252158
• DOI: http://doi.org/10.5045/kjh.2009.44.2.117

Abstract

We present the case of a 34-year-old man with acute biphenotype leukemia that co-expressed B-lymphoid and myeloid antigen after the diagnosis of pulmonary alveolar proteinosis (PAP). The diagnosis of PAP was established by Periodic Acid-Schiff reaction staining on the Video Associated Thoracoscope guided lung biopsy and biphenotype leukemia was revealed by immunohistochemical stains of the blasts harvested from the bone marrow biopsy. Supposedly, PAP follows a hematologic malignancy, yet this case shows the reverse sequence.

Keyword

Pulmonary alveolar proteinosis; Acute biphenotype leukemia; B-lymphoid; Myeloid

MeSH Terms

Adult
Biopsy
Bone Marrow
Coloring Agents
Hematologic Neoplasms
Humans
Leukemia
Lung
Periodic Acid-Schiff Reaction
Pulmonary Alveolar Proteinosis
Thoracoscopes
Coloring Agents

Figure

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  Fig. 1. VATS lung biopsy. VATS biopsy showed many homogeneous, eosinophilic diastase-resistant PAS reactive material deposition in intra alveolar space (H&E ×400).

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  Fig. 2. Computed tomography done before (A) and after (B) whole lung lavage.

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  Fig. 3. BM aspiration. BM aspiration showed several undifferentiated blasts.

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  Fig. 4. Cytogenetic study showed BCR/ABL1 gene rearrangement.

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  Fig. 5. Plain chest X-ray and computed chest tomography at 2nd admission. X-ray showed interval increasing extent of crazy paving appearance and ground glass opacity in both lungs.

Reference

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