1985 Volume 26 Issue 4 Pages 560-565
A 40-year-old man born in Onagawa, a town in Miyagi prefecture, visited Ishinomaki Red Cross Hospital with erythema on his face and legs in 1977. At that time, there was no lymphnode enlargement nor hepatosplenomegaly. His WBC was 13,200/μl with 38% abnormal lymphocytes having lobulated or convoluted nuclei. The 97.7% of these abnormal cells were T cell and 70% of these cells were positive for PAS stain. The bone marrow showed very mild infiltration (0.2%). The ATLA antibody titer was ×20 positive. He was treated with cyclophosphamide 50mg p.o. for 15 months and his erythema completely disappeared. Thereafter he discontinued the therapy for more than 4 years until 1982.
At the time of his second admission, he had no erythema but systemic lymphnode swelling. His WBC was 5,800/μl in which abnormal lymphocytes were only 4%. The biopsy specimen of the lymphnode was diagnosed diffuse pleomorphic type non-Hodgkin lymphoma in LSG classification. He was treated with CHOP but with little response and finally died of intracranial bleeding.
His autopsy findings revealed the spreading of malignant cells to lmphnodes, bone marrow, and pancreas.