抄録
A 52-year-old man with chronic myeloid leukemia, for whom elective splenectomy had performed in chronic phase in order to prolong the survival period, developed thrombocytosis, more than 250×104/mm3, with resultant angina-like symptoms and syncopal attacks between 3 and 6 years after splenectomy. Treatment with ACNU and periodic thrombopheresis had partial success. Seven years after splenectomy, he admitted because of weakness, jaundice, ascites, edema and shortness of breath. Examination resulted in the discovery of hepatic insufficiency, earry stage of blast crisis, ARDS and prerenal azothemia, and he died in a few days. Autopsy revealed esophageal varices and marked cell infiltraion into many organs, especially in the liver, kidney and lung. There were vigorous cell infiltratin and extramedullary hematopoiesis in the hepatic sinusoid with many small noduls containing monotonous blastoid cells leading to atrophy, degeneration and loss of hepatic cells.
Only one case of chronic myeloid leukemia, which converted blast phase by hepatic insufficiency as to the first manifestation, has been descrived.
