Myelodysplasia presenting with pulmonary manifestations associated with neutrophilic dermatosis.

We present the case of a patient who suffered from severe pneumonia. Extensive diagnostic procedures revealed negative cultures and a severe neutrophilia in the bronchoalveolar lavage fluid suggestive of Sweet's syndrome. The persistent toxic leukocyte differentiation (not induced by infection) suggested an underlying hematologic disorder. One week later, she developed cutaneous lesions indicative of neutrophilic dermatosis. Bone marrow investigation showed refractory anemia with excess of blasts (RAEB). Both the pulmonary and cutaneous infiltrates improved after treatment with chemotherapy.