Skin Lesions and Pulmonary Infiltrates in Acute Myelogenous Leukemia

Abstract

A 27-year-old white woman with ovarian dysgerminoma underwent surgical resection and chemotherapy with adriamycin, cyclophosphamide and methotrexate. Two years later, she developed acute myelogenous leukemia, which was thought to have been induced by the chemotherapeutic regimen. She then received high dose cytarabine and daunorubicin and responded with a partial remission. Follow-up bone marrow examination revealed increased blast forms, and she was treated with low-dose cytarabine. This therapy was discontinued secondary to cytarabine-induced hepatitis. Subsequently, the patient did reasonably well, but required regular platelet and red blood cell transfusions. Several months later, she developed symptoms of recurrent sinusitis and complained of painful red lesions on her thighs and lower legs. These skin lesions steadily increased in size and number and became increasingly tender. Fever as high as 102°F developed. She was admitted for further evaluation and therapy.