Leukemic mastopathy

Excerpt

A previously healthy 26-year-old woman presented to her gynecologist with painful swelling of both breasts. Suspected diagnosis was fibrocystic mastopathy (Fig. 1a). As petechial bleeding of the lower extremities was found during physical examination, she was admitted to the hospital for evaluation. Laboratory test results included thrombocytopenia and leukocytosis of 212,700/µl. Flow cytometry analysis uncovered cortical acute T-lymphoblastic leukemia (T-ALL). Computed tomography of the chest revealed a large, anterior mediastinal mass measuring 9.2 × 9.3 × 13.2 cm (a common finding in T-ALL) and leukemic infiltrates of both breasts (Fig. 1b). Cytomorphology confirmed the presence of lymphatic blasts (Fig. 1c). The patient received chemotherapy containing dexamethasone and cyclophosphamide with substantial improvement in her symptoms (Fig. 1d). A follow-up CT scan revealed disappearance of leukemic infiltrates and a marked decrease in the size of the mediastinal mass (Fig. 1e).

…