Sudden death due to leukostasis in a subject with undiagnosed chronic lymphocytic leukemia.
Autopsy
Chronic lymphocytic leukemia
Forensic sciences
Hyperleukocytosis
Leukostasis
Sudden death
Journal
Forensic science, medicine, and pathology
ISSN: 1556-2891
Titre abrégé: Forensic Sci Med Pathol
Pays: United States
ID NLM: 101236111
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
accepted:
04
07
2021
pubmed:
21
8
2021
medline:
29
1
2022
entrez:
20
8
2021
Statut:
ppublish
Résumé
Sudden death due to leukostasis and lymphocyte thrombi in patients with chronic hematologic malignancies is rare. Leukostasis is characterized by highly elevated leukemic cell count and decreased tissue perfusion symptoms, leading to severe complications and even death. Chronic lymphocytic leukemia (CLL) is a chronic lymphoproliferative disorder that shows a highly heterogeneous clinical course, ranging from indolent form to very aggressive disease. Due to its low metabolic and mitotic rate, there is a lower incidence of clinically significant leukostasis in patients with CLL. Two main theories have been proposed in the development of leukostasis: (1) increased blood viscosity due to large leukemic cell populations; (2) high metabolic activity and cytokine production by leukemic cells. Both mechanisms lead to local hypoxic damage.We present a case of a 70-year-old man who died suddenly in the absence of symptoms. Autopsy and histology examinations revealed findings consistent with CLL and diffuse leukostasis involving the major organs' vessels.In the presence of gross and/or microscopic findings suggesting a potential hematologic malignancy, undiagnosed or relapsing hematologic malignancies should be considered in the differential diagnosis of sudden deaths.
Identifiants
pubmed: 34415512
doi: 10.1007/s12024-021-00406-9
pii: 10.1007/s12024-021-00406-9
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
693-699Informations de copyright
© 2021. Springer Science+Business Media, LLC, part of Springer Nature.
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