Acute respiratory failure in hyperleukocytotic acute myeloid leukemia: The role of perfusion lung scintigraphy

Abstract
A patient with acute hyperleukocytotic myelogenous leukemia who presented with acute respiratory distress is reported. Clinical manifestations included dyspnea, tachypnea, hyperventilation, and cyanosis. Blood gas analysis revealed hypoxemia, hypocapnia, and metabolic acidosis. Chest X‐ray and perfusion lung scanning were normal. Pulmonary leukostastis syndrome (PLS) was later confirmed at autopsy. In a patient with hyperleukocytosis from acute nonlymphocytic leukemia and respiratory distress, a normal perfusion lung scintigraph should make one consider the PLS.