Drastic Multiorgan Dysfunction Due to Severe Leukostasis: A Case Report

Abstract

Leukostasis is a life-threatening complication that causes vascular occlusion leading to organ damage in leukemia patients. Organs with impairment due to leukostasis are usually the lungs and kidneys, but other organs may also be damaged. We experienced an autopsy case of severe infarction in multiple organs including the spleen probably due to leukostasis in a patient with acute myeloid leukemia.

Keywords: acute myeloid leukemia; end-stage; hyperleukocytosis; leukostasis; multiple organ dysfunction; multiple organ infarction.

Figure 1. Microscopic findings of bone marrow.

(A) Low power view of bone marrow. H&E staining 4x, Bar: 500 μm (B) High power view of bone marrow. H&E staining 4x, Bar: 50 μm (C) High power view of bone marrow. MPO staining 40x, Bar: 50 μm

Figure 2. Macroscopic and microscopic findings.

(A) Necrotic area on the cut surface of the spleen. (B) Necrotic tissue of the spleen. H&E staining 4x, Bar: 500 μm (C) Leukemic infiltration and hemorrhage in the lungs. H&E staining 4x, Bar: 500 μm (D) A blood vessel filled with leukemic cells in the lungs. H&E staining 20x, Bar: 100 μm (E) The leukemic cells were arranged along the alveolar walls. MPO staining 10x, Bar: 200 μm (F) Extensive coagulative necrosis in the liver. H&E staining 10x, Bar: 200 μm (G) Coagulative necrosis and leukemic infiltration of the pancreas. H&E staining 20x, Bar: 100 μm (H) Coagulative necrosis of renal glomeruli (arrows) and leukemic cell infiltration. H&E staining 20x, Bar: 100 μm