Leukemia is a malignant disease of the hematopoietic system. Many patients often present with pharyngeal lesions in the early stages, manifested as ulcerative necrosis of the tonsils and pharyngeal isthmus, known as leukemic angina.

bubble_chart Etiology

Due to the abnormal proliferation of white blood cells, a large number of abnormal leukemia cells can be produced, which extensively infiltrate various tissues and organs in the body, leading to different clinical manifestations.

bubble_chart Clinical Manifestations

At the onset of acute leukemia, there is often irregular fever, followed by high fever and shivering. The general condition deteriorates rapidly, quickly leading to toxic symptoms and circulatory failure. If the constitution is extremely poor, there may be no fever, only low-grade fever.

The mucous membrane of the throat becomes edematous and pale, with static blood spots or ecchymoses on the pharyngeal wall, tonsils, and soft palate. Secondary infections invading the mucous membrane, submucosal layer, and even deep into the muscle layer can cause necrosis and ulcers, covered with a gray-white pseudomembrane. In severe cases, the necrotic tissue appears brownish and shows a tendency to bleed. The lymphoid tissue of the tonsils and base of the tongue does not show inflammatory swelling. In the early stages of acute leukemia, there is often painless lymph node enlargement in various parts of the body. Ulceration in the throat can cause severe pain, difficulty swallowing, fetid mouth odor, and sometimes restricted mouth opening.

bubble_chart Diagnosis

The onset is sudden, with symptoms, signs, and a medical history suggestive of leukemia. The pharynx exhibits typical necrotic tissue manifestations, and laboratory tests reveal a sharp increase in white blood cells, including blasts and immature cells, with these changes being more pronounced in the bone marrow picture. In contrast, malignant granuloma of the pharynx usually has a slow onset, with good general condition in the early stages, ulceration of the pharynx but minimal pain, and necrotic areas mostly located along the midline, which helps in differentiation.

The main approach is systemic treatment, providing supportive therapy to enhance the body's resistance. Antibiotics are used to control infections, while local mouthwash solutions can be applied to maintain oral and pharyngeal hygiene, along with symptomatic management.