The terminal chest radiographs of ten patients with pulmonary leukostasis were correlated with the autopsy findings. In six patients, no abnormalities attributable to leukostasis were seen on chest radiographs. In four patients, diffuse alveolar consolidations were caused by alveolar edema following leukostasis. Leukostasis should be considered in leukemia patients with severe dyspnea who have normal chest radiographs or diffuse alveolar edema.