抄録
A case that could be classified as “monocytic sarcoma of the peritoneal type” was described, which presented ascites, and diffuse peritoneal and retroperitoneal infiltration, with minimal involvement of the bone marrow and peripheral blood throughout the course.
The patient was 27 years old, male, who visited our hospital on May, 1976 with chief complaints of abdominal distension and the tumor of right sided spermatic cord.
The cytological examination revealed that the neoplastic cells in ascites had the characteristics of monocyte as evidenced by peroxidase (+), India-ink phagocytosis (+), acid-phosphatase (+), α-naphthyl acetate esterase (+)-(-), PAS (+). In addition, immunological examination disclosed that the cells had Fc recepter, C3 recepter and immunophagocytosis, which were also characteristics of monocyte. However, there was no leukemic manifestation until 6 months from the time of initial diagnosis, when there was subleukemic manifestation of about 10% tumor cells in the peripheral blood and bone marrow. In the peripheral blood, leukemic cells increased to 50%∼80% in terminal stage associated with leukopenia (3,000/cmm>). Finally he died of ileus, 12 months after initial diagnosis.
Autopsy revealed the infiltration of the neoplastic cells in the peritoneum, omentum, retroperitoneum, diaphragma, but not in the bone marrow, liver, spleen. Therefore, this case could be classified as “monocytic sarcoma of the peritoneal type”. Literature is reviewed with emphasis on report of granulocytic sarcoma or chloroma occurring in the absence of leukemia. Then, for differential diagnosis, importance of employing immunological surface marker as well as cyto-chemical and ultrastructural method is pointed out.
