2008 Volume 54 Issue 3 Pages 206-209
Aplastic anemia is a blood disease characterized by pancytopenia due to a decrease in hematopoieticstem cells. We describe a patient who presented with submucosal hematoma of the tongue and was given a diagnosisof aplastic anemia. The patient was a 24-year-old man who visited our department because of a hematoma ofthe tongue. Two days before presentation, a dark reddish tumor with a diameter of 1-2mm was noticed at the leftmargin of the tongue. At presentation, a 20×11mm dark reddish elevation was seen at the left lateral margin ofthe tongue. On the basis of the above course and findings, a hematoma was diagnosed, and blood tests were conducted.A blood disease was suspected. The white blood cell count was 500/μl, the red blood cell count was320×104/μl, the Hb was 11.2g/dl, the Ht was 31.1%, the MCV was 96.9 fl, the MCH was 35.0 pg, the MCHCwas 36.1%, and the platelet count was 0.3×104/μl, indicating pancytopenia. A submucosal hematoma of thetongue accompanied by pancytopenia was diagnosed, and detailed examinations were performed at the hematologydepartment. A bone marrow puncture test showed that the bone marrow cell count was 4, 000/μl and themegakaryocyte count was 0/μl; aplastic anemia was thus diagnosed, and the patient received immunosuppressivetherapy. Even when the onset is gradual, aplastic anemia can be lethal if detection is late and appropriate therapyis not administered. Therefore, if the regional cause of an oral hematoma is not clear, close follow-up is necessary.If systemic factors are suspected, blood tests should be promptly performed.
