J Cardiovasc Ultrasound.  2016 Jun;24(2):174-176. 10.4250/jcu.2016.24.2.174.

Acute Myeloid Leukemia with Intracardiac Thrombus Presenting as Acute Limb Ischemia

• Kharwar RB
• Sharma K
• Jain S

• KMID: 2308711
• DOI: http://doi.org/10.4250/jcu.2016.24.2.174

Abstract

No abstract available.

Keyword

Acute myeloid leukemia; Acute limb ischemia; Thrombus

MeSH Terms

Extremities*
Ischemia*
Leukemia, Myeloid, Acute*
Thrombosis*

Figure

• 

  Fig. 1 Computed tomographic angiography of aorta with both lower limb. There is a partially occluding thrombus at the lower aorta just before the bifurcation along with complete thrombotic occlusion of the left common iliac artery from the origin. A: The left common femoral artery is being filled by collateral from the contralateral limb. B: The three dimensional computed tomographic reconstruction. CIA: common iliac artery.

• 

  Fig. 2 Transthoracic echocardiography. A: Two dimensional echocardiography in apical four chamber view (A) showing normal sized LV with a 2.0 × 3.0 cm thrombus at the apico-septal region. B: The three dimensional (3D) structure of the thrombus is better appreciated on 3D transthoracic echocardiography. LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle.

• 

  Fig. 3 Peripheral blood smear at 400 × magnification (A) and 1000 × magnification (B) using Wright stain. A: There are plenty of blast in the peripheral smear which can be identified by hyperchromatic nuclei with a raised nucleus/cytoplasm ratio. Also note the scarcity of platelets. B: Magnified view of the blast cells.

Reference

1. Kafetzakis A, Foundoulakis A, Ioannou CV, Stavroulaki E, Koutsopoulos A, Katsamouris AN. Acute lower limb ischemia as the initial symptom of acute myeloid leukemia. Vasc Med. 2007; 12:199–202.

2. Cahill TJ, Chowdhury O, Myerson SG, Ormerod O, Herring N, Grimwade D, Littlewood T, Peniket A. Myocardial infarction with intracardiac thrombosis as the presentation of acute promyelocytic leukemia: diagnosis and follow-up by cardiac magnetic resonance imaging. Circulation. 2011; 123:e370–e372.