Atypical Presentation of Acute Myeloid Leukaemia: A Series of Three Cases
Acute Myeloid Leukaemia (AML) is a haematological malignancy characterised by the infiltration of the blood, bone marrow and other tissues by proliferative, clonal, poorly differentiated cells of the haematopoietic system. Diagnosis can be suspected by the presence of atypical cells on a peripheral...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=OR01-OR05&id=21233 |
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| Summary: | Acute Myeloid Leukaemia (AML) is a haematological malignancy characterised by the infiltration of the blood, bone marrow and other tissues by proliferative, clonal, poorly differentiated cells of the haematopoietic system. Diagnosis can be suspected by the presence of atypical cells on a peripheral blood smear and confirmed by bone marrow aspiration studies and immunohistochemistry. Detection of AML in the first trimester of pregnancy is a rare phenomenon. The rarity of haematological malignancies, especially in the first trimester, poses challenges in the diagnosis, treatment and management of leukaemias during pregnancy. AML masquerading as acute and chronic infections also presents diagnostic and consequent therapeutic challenges. Hence, multidisciplinary treatment is key to the outcomes of these rare presentations. The following is a case series highlighting the varied ways in which AML can present to a physician, often requiring a high degree of suspicion to warrant further investigation. The first case discusses the difficulties encountered in diagnosing and treating a primigravida woman in her first trimester, which ultimately led to the termination of her pregnancy and subsequent chemotherapy cycles. The second case involves a female in her 40’s presenting with complaints of chronic sinusitis, who was diagnosed with AML upon evaluation. This case was challenging as infiltrative lesions of leukaemia were considered during the assessment. The patient was managed with a carefully formulated regimen of chemotherapeutic agents and antibiotics. The third case presented with acute pyelonephritis, illuminating the rapid deterioration associated with the perils of undiagnosed haematological malignancies. Together, these three cases underscore the various presentations of AML, highlighting the necessity for a high degree of suspicion even in seemingly uncomplicated cases such as chronic sinusitis or acute abdominal pain, such as pyelonephritis. Haematological malignancies are commonly suspected when more aggressive symptoms, such as fever, bleeding gums, or generalised lymphadenopathy, are present. This case series aims to draw attention to the simpler presentations that may be overlooked in outpatient settings as benign infections. |
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| ISSN: | 2249-782X 0973-709X |