Gingival Infiltration in Acute Monocytic Leukemia

This post is an answer to the Case – Fatigue and Painful, Swollen Gums

A peripheral-blood smear showed myeloblasts with Auer rods, and flow cytometry revealed 89% blasts. A bone marrow biopsy also showed 89% blasts, with positive staining for CD34, CD117, and myeloperoxidase, confirming a diagnosis of acute monocytic leukemia.

A chimeric trisomy 4 mutation was identified on cytogenetic analysis. No abnormalities were detected on next-generation sequencing.

Gingival infiltration by leukemic cells may be a sign of acute myeloid leukemia, especially in patients with a monocytic subtype.

After the initiation of treatment with hydroxyurea and chemotherapy, the gingival swelling abated and the leukemia went into remission. Since then, the patient has been receiving treatment with consolidation chemotherapy and undergoing evaluation for hematopoietic stem-cell transplantation.


  • Eduardo Morato de Oliveira, Cinthia Veronica Bardález López de Cáceres, Alan Roger Santos-Silva, Pablo Agustin Vargas, Márcio Ajudarte Lopes, Hélder Antônio Rebelo Pontes, Flávia Sirotheau Corrêa Pontes, Ricardo Alves Mesquita, Silvia Ferreira de Sousa, Lucas Guimarães Abreu, José Cândido Caldeira Xavier, Bruno Augusto Benevenuto de Andrade, Júlio Cesar Tanos Lacerda, Renata Gonçalves Resende, Ramiro Alejandro Tomasi, Felipe Paiva Fonseca,Clinical diagnostic approach for oral lymphomas: a multi-institutional, observational study based on 107 cases, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 136, 4, (427-435), (2023).