Abstract
Congenital leukemia is a very rare condition. This report deals with two autopsied cases of congenital leukemia without Down's syndrome.
Case 1. A premature newborn female of 38 weeks gestational period was born to healthy parents. Her weight was 2,400 gm. The pregnancy was uneventfull, except the correction of the breech presentation under the fluoroscopy. Numerous hemorrhagic skin nodules were disseminated over the entire body. Her symptoms were suspected to be due to congenital leukemia, but the hematological examination was not done. The infant died six hours after delivery. The autopsy revealed hepatomegaly (395 gm), splenomegaly (27 gm) and lymphadenopathy. Any anomaly was not observed. Microscopically the extramedullary infiltration of leukemia cells was massive, and few organs were spared from the infiltration. The leukemia cells were composed of myeloblasts, promyelocytes and myelocytes.
Case 2. The female baby was born at full term. Her weight was 3,350 gm. At birth there was purpura at the abdominal wall and the right cheek. At 4 weeks of age skin nodules were observed. Hepatosplenomegaly was apparent. Laboratory examinations were as follows: RBC 239×104/cmm, Plt 3×104/cmm, WBC 14,400/cmm (unclassified immature cells 91%). Antileukemic agents brought a hematological remission, but she died at six months and three weeks of age because of the cytomegalovirus infection. The autopsy revealed the scarcity of the leukemia cells which were observed only in the bone marrow and the pleura. The leukemia cells in the section were positive to Sudan Black B stain and diagnosed as myelogenous.
It seems likely that “congenital leukemia” is a condition different from leukemia of infancy and childhood.
