Abstract
A 67 year-old female was admitted to our hospital because of marked leukocytosis and hepatosplenomegaly. On admission, red cell, leukocyte and platelet counts were 512×104, 82.8×103 and 16.3×104/mm3 respectively. The analysis of peripheral blood smear showed marked increase of mature neutrophils (band 14; segmented 82; eosinophils 2 and lymphocytes 2%). NAP score was as high as 342. Hypercellularity of myeloid cells at various maturational stages was seen in bone marrow smears. The karyotype was a normal female pattern. According to these findings, a diagnosis of chronic neutrophilic leukemia was made for this patient. Marrow CFU-C, CFU-E and peripheral CFU-C were increased. Liver biopsy revealed sinusoidal infiltration of mature neutrophils, which seemed to cause hepatosplenomegaly without primary liver disease.
During the follow up period of 10 months, neutrophils gradually increased to 100×103/mm3 or more, and on the other hand, red cells decreased to 396×104 and pletelets to 4.0×104/mm3.
