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RESUMEN:
El síndrome de diferenciación (SD) se presenta secundario al tratamiento en pacientes con leucemia promielocítica aguda en las primeras semanas de inducción. Se caracteriza por un conjunto de signos y síntomas como disnea, registros febriles, aumento de peso, hipotensión arterial e insuficiencia renal entre los más frecuentes. El SD tiene una alta tasa de mortalidad, y de ahí la importancia de acceder a un diagnóstico temprano, el cual puede brindarse en conjunto con la sospecha clínica a través de estudios de imágenes, principalmente de la tomografía computarizada de tórax. En el presente trabajo se exponen cuatro casos clínicos en los que los hallazgos tomográficos contribuyeron en el diagnóstico de SD y orientaron a una conducta terapéutica. Los objetivos son repasar las bases fisiopatológicas de la leucemia promielocítica aguda y el SD, conocer los patrones pulmonares del SD, identificar los probables diagnósticos diferenciales y reconocer el escenario clínico del SD.

Abstract:
Differentiation syndrome (DS) occurs secondary to treatment in patients with acute promyelocytic leukemia in the first weeks of induction. The DS is characterized by a set of signs and symptoms such as dyspnea, fever, weight gain, hypotension and renal failure among the most frequent. This syndrome has a high mortality rate, hence the importance of an early diagnosis that can be made in conjunction with clinical suspicion through imaging tests, especially chest tomography. In the present work, four clinical cases are presented and the tomographic findings contributed to the diagnosis of DS and guided the therapeutic approach. The objectives of this communication are to review the pathophysiological bases of promyelocytic leukemia and DS, to know the pulmonary patterns of DS, to identify the probable differential diagnoses and to recognize the clinical picture of DS.

Abstract:
Differentiation syndrome (DS) occurs secondary to treatment in patients with acute promyelocytic leukemia in the first weeks of induction. The DS is characterized by a set of signs and symptoms such as dyspnea, fever, weight gain, hypotension and renal failure among the most frequent. This syndrome has a high mortality rate, hence the importance of an early diagnosis that can be made in conjunction with clinical suspicion through imaging tests, especially chest tomography. In the present work, four clinical cases are presented and the tomographic findings contributed to the diagnosis of DS and guided the therapeutic approach. The objectives of this communication are to review the pathophysiological bases of promyelocytic leukemia and DS, to know the pulmonary patterns of DS, to identify the probable differential diagnoses and to recognize the clinical picture of DS.