Journal of Clinical Respiratory Diseases & Care: Acesso Aberto

Acute Respiratory Failure in a Patient Presenting T-cell Prolymphocytic Leukemia: Specific Leukemic Lung Involvement?

Abstract

Kim Blanc , Aurélie Lefebvre, Nicolas Chapuis, Jerome Tamburini, Bouscary Didier, Felipe Suarez, Laurent Frenzel and Antoine Rabbat

A 36-year old patient with relapsing T-cell prolymphocytic leukemia was admitted in intensive care unit for acute respiratory failure and pulmonary infiltrates. A flexible bronchoscopy with bronchoalveolar lavage was performed while the patient was under noninvasive ventilation. Cytological examination and immunophenotyping of BAL lymphoid cells confirmed the diagnosis of lung infiltration with prolymphocytic T-cell leukemia. An associated organized pneumonia was suspected. The rapid clinical and radiological response to corticosteroids followed by immunotherapy with alemtuzumab strengthened our hypothesis. To our knowledge, this is the first reported case of prolymphocytic T-cell leukemia with a specific pulmonary lung involvement associated with an organized pneumonia.