Abstract
A 69-year-old female was admitted with high fever abdominal pain. Laboratory findings showed high serum LDH (2930W.U) and thrombocytopenia (5.2×104/μl ). CT revealed hepatosplenomegaly, ascites and mild pleural effusions. Bone marrow aspiration showed normocellularity with 23.4% immature atypical cells showing various range of maturation and cytophagocytosis by mature histiocytes (1.2%). Cytogenetic study delineated a clone with 48, XX, 1q+, 1p-, 7q+, 9p+, +12, 13q-, -14, 17p+, 18p+, 19q+, +mar, +mar. This patient progressively deteriolated with icterus, bleeding tendency and ventricular arrythmias and suddenly died of fatal arrythmia. At the terminal stage, many immature cells appeared in the peripheral blood, which provided the opportunity of studying by electron microscopy, by cell membrane marker classification and also by culture of malignant cells. These findings suggested the histiomonocytic origin of the abnormal cells. The diagnosis of malignant histiocytosis was based on clinical manifestation, morphologic features, immunocytochemical studies and chromosomal abnormalities.
