Abstract
A 25-year-old man was transferred to our department from a local hospital on December 15, 1967 for diagnostic examinations for anemia and lumbago.
The patient was well until August 1967 when fatigue and cardiac parpitation were noted more than expected with a mountain climb. The patient, however, did not see a physician until December 7, when the symptoms mentioned above became gradually worse in addition to recent development of lumbago. Anemia of RBC 225×104, Hb 45% (Sahli) was found, and the patient was transferred to our department.
Physical examination on admission was essentially negative except for generalized anemic appearance. Spleen and lymphnodes were not palpable. A marked anemia of hemoglobin 5.49 g/100 ml and a prolongation of plasma clot time were seen.
Bone marrow aspiration was dry tap, and a hemolytic anemia was diagnosed with a high plasma hemoglobin level of 769 mg/100 ml. Blood transfusion caused an elevation of body temperature up to 38°C and did not increase hemoglobin volume as calculated. The patient died on the 15th hospital day, and the autopsy revealed a small carcinoma at the cardia of the stomach with a dissiminated metastasis to the liver, spleen, bone marrow, and others. Microangiopathy with massive tumor thrombi was found in the lungs and kidneys.
