Abstract
A 37-year-old male was admitted to our hospital, because of spiking fever which did not respond to the administration of antibiotics. On admission, there was marked hepatosplenomegaly, but no lymphadenopathy.
Peripheral blood examination showed pancytopenia, and a bone marrow aspiration revealed hypoplasia and smears showed almost normal except for very low percentage of unclassified abnormal cells. Other abnormal laboratory data includes slight elevation of GOT and GPT. In spite of the administration of some antibiotics, high fever continued and the physical status was deteriorated. The second bone marrow aspiration revealed immature lymphoid cells and VP therapy was started, resulting in poor response and progression of pancytopenia and liver dysfunction. Serial bone marrow aspirations performed during this period revealed some immature histiocytes phagocytizing red cells or thrombocytes, and a final diagnosis as malignant histiocytosis (M. H.) was made. ACNU in a dose of 120 mg (2 mg/kg) was administered and the marked improvement of clinical and hematological findings was achieved in a short period.
The clinical course of this patient suggested that frequent aspirations of bone marrow were useful for the diagnosis of M. H. and that ACNU would be one of the drugs of choice for the treatment of M. H..
