Cervical Lymphadenopathy in Concomitant CML and Tuberculosis: A Case Report.

Abstract

Introduction: Chronic myeloid leukemia is a myeloproliferative disorder characterized by the uncontrolled proliferation of mature and maturing granulocytes in the bone marrow, along with the presence of the Philadelphia chromosome. Lymphadenopathy is an uncommon initial manifestation of CML and is typically attributed to the disease itself. However, with the use of tyrosine kinase inhibitors (TKIs), which can affect T-cell-mediated immunity, new or persistent lymphadenopathy in CML patients warrants investigation to rule out opportunistic infections, including tuberculosis (TB), or progression to the blast phase of CML.

Case presentation: A 35-year-old male diagnosed with chronic-phase CML initially presented with cervical lymphadenopathy. The lymphadenopathy was initially attributed to CML. Further evaluation, including a lymph node biopsy, revealed concurrent TB infection. Treatment with appropriate anti-tuberculous therapy led to the resolution of the lymphadenopathy.

Conclusion: This case highlights the importance of considering opportunistic infections, such as TB, in CML patients presenting with lymphadenopathy, particularly those on TKI therapy. Prompt investigation and appropriate management are crucial to avoid complications and ensure optimal patient outcomes.