抄録
A 27-year-old Japanese female with 11 weeks' gestation was admitted because of progressive swelling of right cervical tumor in May, 1984. Her hematovrit was 39%; WBC, 7300/cmm with a normal differential counts; LDH, 1,300 mU/ml. The right cervical tumor was fist-sized and demonstrated to be thyroid origin by isotope scans, ultrasound tomography and computed tomography. In addition, stomach, colon, abdomen, liver and cervical lymph nodes were involved on admission. Microscopically, cervical lymph node was composed of sheets of packed undifferentiated lymphocytes. The cytoplasm of these cells was strongly positive with methyl-green-pyronin staining but negative with periodic acid-Schiff staining. Foaming histiocytes containing nuclear debris interspersed among the tumor cells disclosed the typical “starry sky” pattern. Surface phenotype of tumor cells had monoclonal B cell nature (μ, κ). The cells were also positive with OKIal and B1 monoclonal antibodies and negative with EBNA. Therefore, the diagnosis of Burkitt's lymphoma was made.
After VEPA therapy, complete remission was obtained in July, 1984. A rapid relapse with signs of CNS involvement has been occurred in August. Skull irradiation and intrathecal injections of methotrexate and cytosine arabinoside could induce complete remission one month later. In October, however, leukemic transformation was developed and she died of sepsis in December. Chromosome analysis from peripheral blood in the phase of leukemic transformation revealed t(8;14)(q24;p32) with additional abnormalities including dup(1p), i(3p) and 1q trisomy.
