A male patient, aged 40 day, was admitted to our hospital in October, 1977, for evaluation of skin nodules noticed at birth. On admission, a hematological examination showed no leukemic change. Skin biopsies were performed, but no diagnosis was established. At the age of two months, leukemic cells appeared in the peripheral blood and bone marrow. Leukemic cells showed varying degrees of activity for peroxidase, non-specific esterase, and intracytoplasmic muramidase, and showed latex-particle phagocytosis in vitro and erythrophagocytosis in the tissue section. From examination of the cytochemical patterns as well as from the morphological features a diagnosis of acute monocytic leukemia was made.
Shortly after initiation of remission induction therapy, the skin nodules diminished in size, but the patient died of pneumonia and sepsis.
