Photo Quiz: Sixty-Year-Old Woman with a History of Acute Lymphoblastic Leukemia Presents with Respiratory Symptoms.

A 60-year-old woman presented to the emergency department with a recent history of a dry cough that later progressed to produce green/white sputum. She also exhibited dyspnea on exertion. There was no history of fever, chills, night sweats, or weight loss. Her medical history was significant for a Philadelphia chromosome-negative, acute lymphoblastic leukemia status post induction therapy with cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride, and dexamethasone (Hyper-CVAD) and intrathecal chemotherapy for central nervous system prophylaxis.