本研究通过对 46 例尸检病例（年龄 >12 岁）进行 14 年（2009-2022 年）分析，调查急性髓系白血病/淋巴细胞白血病 (AML/ALL)。 B-ALL 是主要亚型（34.8%）。肝脏和脾脏是活动性白血病的常见部位（63%）。呼吸困难和感觉改变等症状与心脏 (p = .031) 和大脑白细胞停滞 (p = .006) 显着相关。可测量残留病 (MRD) 阴性与骨髓外无病状态相关，而 MRD 阳性病例则显示白血病浸润。在 23 例尸检病例中发现了感染，尤其与引产后和移植后死亡有关。令人惊讶的是，这 23 例中有 18 例出现意外感染，主要是真菌感染（13 例），其中曲霉菌属最常见。 48% 的病例发现诊断差异。恶性浸润（46%）和感染（25%）是死亡的主要原因。这项研究揭示了髓外组织中的白血病，揭示了新的临床病理关联，并强调了被忽视的治疗副作用，为未来的病例管理提供了见解。

This study investigates acute myeloid leukemia/lymphoblastic leukemia (AML/ALL) through a 14-year analysis (2009-2022) of 46 autopsied cases (age >12 years). B-ALL was the dominant subtype (34.8%). Liver and spleen were the common sites of active leukemia (63% cases). Symptoms like dyspnea and altered sensorium associated significantly with heart (p = .031) and brain leukostasis (p = .006). Measurable residual disease (MRD) negativity correlated with disease-free status outside the bone marrow, while MRD-positive cases displayed leukemic infiltrates. Infections were identified in 23 autopsied cases, notably linked to post-induction and post-transplant fatalities. Surprisingly, 18 of these 23 cases had unexpected infections mainly fungal (13 cases) with Aspergillus species as the most common. Diagnostic discrepancies were identified in 48% of cases. Malignant infiltration (46%) and infections (25%) were the leading causes of death. This research sheds light on leukemia in extra-medullary tissues, uncovers novel clinical-pathological associations, and highlights overlooked therapy side effects, offering insights for future case management.