The Common Vein

• 40y.o. male recently diagnosed with atypical chronic myeloid leukemia (aCML) after presenting with fevers and malaise
• Associated findings
  • Splenomegaly 15.5 cm
  • transfusion-dependent macrocytic anemia and
  • 10% circulating blasts with myeloid phenotype
  • bone marrow biopsy
    • suggested myeloproliferative disorder rather than AML,
      • most consistent with CML,
        • BCR/ABL1 FISH negative.
        • Recommendation
          • Stem cell Tx and
          • Venetoclax
          • Inqovi
    • CXR 3 MONTHS AGO AT TIME OF PRESENTATION

    • 

      40M-atypical-CML-02-CXR-3-months-ago-at-time-of-diagnosisb-e1658863188477.jpg

      40M atypical CML 01 CXR 3 months ago at time of diagnosis
      thecommonvein.net
      Ashley Davidoff MD

      

      

      

      3 months later after starting chemotherapy

    • complained of dyspnea
    • CXR
      •  CXR post chemo shows left lower lobe subsegmental infiltrate and prominent interstitial changes at the bases
    • CT scan
    • subsegmental consolidative opacity in the left lower
      lobe in a background of
      • diffuse bilateral segmental and subsegmental
        airway disease
      • groundglass changes
      • mosaic attenuations and
      • some nodular
        infiltrates.
    • Infectious, inflammatory immunologic (lung toxicity ) etiologies are considered

40M-atypical-CML-08-CXR-current-post-chemo-lung-bases.jpg

40M atypical CML 07 CXR current post chemo shows left lower lobe subsegmental infiltrate and prominent interstitial changes at the bases as well
thecommonvein.net
Ashley Davidoff MD

 

CT Scan