What are clinical manifestations of AML due to organ infiltration?

1. Pain and tenderness of bones (e.g. sternal tenderness) - bone infarcts or subperiosteal infiltrates by leukaemic cells 2. Splenomegaly – mild to moderate 3. Hepatomegaly – mild ; due to leukaemic infiltration but the infiltrates usually do not interfere with the function of the liver 4. Meningeal involvement - raised intracranial pressure, headache, nausea and vomiting, blurring of vision and diplopia (more frequent in ALL during hematologic remission); sudden death from massive intracranial haemorrhage as a result of leucostasis 5. Gum hypertrophy – in M4, M5 6. Skin infiltration – violaceous rash 7. Chloroma/ Granulocytic sarcoma - localised tumour forming mass occurring in the skin or orbit due to local infiltration of the tissues by leukaemic cells. The tumour is greenish in appearance due to the presence of myeloperoxidase