A 50-year-old woman complained of severe anemia and general fatigue was reported as an autopsy case of chronic myelomocytic leukemia (CMyMoL).
With marked enlargement of spleen, moderate hepatomegaly and slight lymphadenopathy, she showed severe macrocytic normochromic anemia, marked leukocytosis with monocytosis up to 23% and slight thrombocytopenia in the peripheral blood.
The bone marrow showed normocellularity, involving an increase of monocytes in each step of maturity.
The important findings reflecting the increase in monocytes were an increase of urine muramidase activity and an increase of the phagocytosis of India-ink. Ph1 chromosome or other abnormalities of chromosomes were not seen and alkaline phosphatase in the neutrophile leukocytes was high.
The autopsy findings indicated that immature, partly mature granulocytic and monocytic leukemic cells diffusely proliferated in the bone marrow, liver, spleen, lymph nodes and other organs.
Thus, the hematological findings of this patient was characterized by an apparent proliferation of mature monocytes in the peripheral blood and a proliferation of monocytes of each step of maturity in the bone marrow.
Although few attention has been paid to a chronic form of MyMoL, this patient was considered to be fit for one case of CMyMoL already reported by Miescher & Farquet.
