Abstract
A case of chronic myelogenous leukemia associated with prominent peripheral lymphadenopathy is reported. A 29-year-old man was first admitted to the Tachikawa Kyosai Hospital because of fever and general malaise. A diagnosis of chronic myelogenous leukemia was established on the basis of anemia, thrombocytosis, marked leukocytosis with shift to the left, marked splenomegaly and positive Ph1 chromosome. He was first placed on busulfan, then 6MP was added. Reduction in WBC and splenomegaly was noted. One month later, he developed fever and enlargement of spleen again, followed by marked generalized peripheral lymphadenopathy. Biopsy of the cervical nodes revealed diffuse infiltration of myeloid cells with all stages of maturation. Imprints of resected nodes, stained with May-Giemsa staining solution, further demonstrated myeloid cell infiltration, in addition, the presence of megakaryocytes and erythroid cells. Double Ph1 chromosome was also demostrated in the culture of biopsied lymphnodes. There was no evidence of acute blastic transformation in the peripheral blood smears or biopsied specimens of bone marrow. Two month later, he developed frank blastic crisis and died of septicemia in spite of intensive treatment with antibiotics and chemotherapeutic agents.
