Abstract
A 27-year-old lineman was admitted to the hospital with generalized lymph node swelling on January 28, 1975. A diagnosis of lymphosarcoma had been made on a biopsy specimen of the left cervical node at another hospital.
On admission examinations revealed the swelling of the bilateral cervical, left axillary and bilateral hilar lymph nodes. Complete remission was not achieved by combination chemotherapy during six weeks by vincristine, cyclophosphamide and prednisolone. At the beginning of July, 1975, swelling of the right cervical nodes was again noted and he was re-admitted on July 17. Irradiation with 60Co and injections of bleomycin were ineffective: numerous lymphosarcoma cells, more than 90 per cent of the nucleated cells appeared in the bone marrow aspirates and peripheral blood and the diagnosis of lymphosarcoma cell leukemia was made. Treatment with BACOP and L-asparaginase gave an excellent result: He was discharged with no swelling of the superficial lymph nodes, absent hepatosplenomegaly, disappearance of lymphosarcoma cells and the normal hematopoiesis in the bone marrow.
On April 17, 1976, swelling of the left cervical nodes reappeared and bone marrow aspirates revealed the findings of lymphosarcoma cell leukemia. During the re-administration of L-asparaginse fever ran high up to 40°C and Escherichia coli was detected from the blood cultures. He succumbed on June 5, 1976.
Autopsy revealed lymphoblastic lymphosarcoma, aspergillosis, pneumonia and bacteremia with Psudomonas aeruginosa.
