25519              ACUTE MYELOID LEUKAEMIA

The patient was a man aged 48 who had had acute myeloid leukaemia for 3 years.  Two years ago a carcinoma of the stomach was discovered and partial gastrectomy was performed.  The gastric tumour recurred and produced pyloric obstruction.  Chemotherapy was continued for leukaemia, but he developed thrombocytopenia and neutropenia, and severe bleeding episodes occurred, including haematemesis and haematuria.

The specimen consists of half a kidney divided in the vertical plane.  The kidney measures 13 cms in length and the cortex is wide and pale and marked congestion of radial vessels.  The pyramids are also congested and a few small petechial haemorrhages are visible in the peripelvic fat.  Histology shows congestion of small vessels and occasional petechial haemorrhages, but there are only a few very small foci of leukaemic infiltration.  Some hyaline casts are visible in occasional tubules.