CLINICAL CASE: Acute Myeloid Leukemia - A case report with palatal and lingual gingival alterations

Leukemia results from the proliferation of a clone of abnormal hematopoietic (HP) cells with impaired differentiation, regulation, and programmed cell death (apoptosis).

Leukemic cell multiplication at the expense of normal HP cell lines causes marrow failure, depressed blood cell count (cytopenia), and death as a result of infection, bleeding, or both.

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Oral lesions may be the presenting feature of acute leukemias and are therefore important diagnostic indicators of the disease. Such lesions may occur due to direct leukemic infiltration of tissues, or be secondary to immunodeficiency, anemia and thrombocytopenia. 

Typical oral manifestations of acute leukemias include gingival swelling, oral ulceration, spontaneous gingival bleeding, petechiae, mucosal pallor, herpetic infections and candidosis.

AML is a clonal proliferation of immature myeloid cells. It presents with marrow failure and cytopenia. Symptoms include fever, fatigue, pallor, mucosal bleeding, petechiae, and local infection.

The French-American-British (FAB) classification system divides AML into 8 subtypes, M0 through to M7, based on the cell type from which the leukemia developed and its degree of maturity. Gingival infiltration represents a 5% frequency as the initial presenting complication of AML.

This report refers to a patient with AML who presented gingival hyperplasia, palatal ecchymoses and other related findings.