Abstract
A patient probably with acute megakaryoblastic leukemia associated with both hypodiploid and hypotetraploid clones is reported. A 59-year-old female was admitted to the hospital because of anemia. There were hepatosplenomegaly on physical examination and pancytopenia with the immature cells on the blood smear. These atypical cells were 25∼35 μm in diameter and negative for peroxidase, PAS, naphthol chroloacetate esterase, α-naphthyl butyrate esterase, but (+)-( ?? ) for acid phosphatase reaction. Aspirations of bone marrow were unsuccessful and a marrow biopsy disclosed diffuse myelofibrosis and loss of active hematopoiesis. Chromosomal analysis of blood without adding mitogenic agents showed 11 hypotetraploid cells of 31 metaphase cells. The diagnosis of acute leukemia was made and chemotherapy was done without success and died about 4.4 month later. Autopsy revealed diffuse bone marrow fibrosis, hepatosplenomegaly, enlarged kidneys and lymph nodes. Histologically showed the marked infiltration of atypical cells resembling to megakaryocytes and their immature forms. Although the origin of blast cells could not be proved clearly, this case is thought to be acute megakaryoblastic leukemia.
