A 63 year old male had repeated episodes of marked submandibular swelling. Antibiotics failed to alter his course of the disease. A biopsy was inconclusive. The diagnosis was not established until bone marrow aspiration was performed, which showed acute myeloid leukemia. The patient responded temporarily with regression of the swelling to anti-leukemic agents but succumbed four months after the diagnosis was made.
In autopsy, the submandibular swelling was of inflammatory nature. The healing of the inflammatory swelling was hindered by the underlying leukemia and thus the diagnosis was initially made difficult.
The authors emphasize that hematologic disorders should be ruled out whenever a persistent inflammation is encountered.