Alveolar-Capillary Block Due to Leukemic Infiltration of the Lung1

The lung is not ordinarily considered a common site of involvement in leukemia. Although autopsy studies have revealed a modest incidence of histologic abnormalities in the lungs, clinical manifestations of pulmonary disease have rarely been reported. In 1955, Nathan and Sanders (1) described a patient with acute myelogenous leukemia in whom pulmonary insufficiency occurred that appeared to be due to leukemic infiltration. The patient's symptoms and roentgenographic abnormalities responded to therapy with amethopterin, On clinical grounds the writel'S characterized the presenting syndrome as one of alveolar-capillary block. It had not previously been suggested that this syndrome could be caused by leukemic involvement of the lung. It is the purpose in the present study to report the clinical, physiologic, and post-mortem findings in a patient with chronic lymphatic leukemia who developed alveolar-capillary block.