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Abstract

ABSTRACT: BACKGROUND: Acute leukemia is a hematological malignancy characterized by an uncontrolled proliferation of hemopietic primitive cells. Presenting features of acute leukemia include fever, anemia, pallor; hepatosplenomegaly &lymphadenopathy, bleeding tendency, bone pain&gum hypertrophy. Intrathoracic manifestations of acute leukemia include infection,mediastinal widening , hemorrhage, infiltration, embolism, edema, pericarditis ´ respiratory distress syndrome. OBJECTIVE: To describe the clinical &radiological respiratory features of acute leukemia at presentation,before starting chemotherapy. PATIENTS AND METHODS: Patients with acute leukemia of age ranged from 15-75 years were incorporated in this study, patients were excluded from the study if they had previous malignancy, lung disease, or if received cytotoxic treatment. Every patient had a detailed history of pulmonary symptoms & chest examination,chest xray examination, sputum samples & pleural aspirates for relevant patients. RESULTS: Of 118 patients with actue leukemia at presentation, 60% of patients were males& 40% were females. Respiratory symptoms including cough,dyspnea&chest pain were found in27.7% of patients (cough 24.4% ,dyspnea 2.5%,chest pain 0.8%) . Respiratory signs including crepitations ,decreased air entry & bronchial breathing were found in 12.5% of patients(crepitation 3.3%, decreased air entry in 6.7%, bronchial breathing in 2.5%). Chest X-ray abnormalities were found in 14.3% of patients ,these include mediastinal widening in 5.9% of patients .Pleural effusion in 4.2% & parenchymal infiltrates in 4.2% of patients CONCLUSION: The chest findings in patient with actue leukemia at presentation were not uncommon. mediastinal widening was the commonest, pleural effusion&parenchymal infiltrates were less common findings

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