Acute promyelocytic leukemia physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]

Overview

The physical examination findings in acute promyelocytic leukemia include petechiae, ecchymoses, mucosal bleeding, splenomegaly, and/or pallor. The bleeding-related physical examination findings have a higher specificity for acute promyelocytic leukemia compared to other types of leukemia.

Physical examination

  • Petechiae: Petechiae are pinpoint hemorrhages in the skin. Petechiae are a result of the coagulopathy (disseminated intravascular coagulation) of acute promyelocytic leukemia. Compared to patients with other types of leukemia, patients with acute promyelocytic leukemia is more likely to present with petechiae.
  • Ecchymoses: Ecchymoses are larger hemorrhages in the skin. Ecchymoses are also known as purpura. Patients with acute promyelocytic leukemia are more likely to have ecchymoses compared to patients with other types of leukemia.
  • Mucosal bleeding: Bleeding from the nares, oral cavity, gastrointestinal tract, and urinary bleeding is common in patients with acute promyelocytic leukemia.[1]
  • Splenomegaly: In some cases, patients with acute promyelocytic leukemia can have enlarged spleens. This is a result of extramedullary hematopoiesis (blood cell production in areas other than the bone marrow. Splenomegaly can cause abdominal discomfort.
  • Pallor: Pallor, or paleness of the skin, is due to the development of anemia, which commonly occurs in patients with acute promyelocytic leukemia.[1]

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