Abstract
A 56 year-old male was admitted to the Niigata University Hospital in April 1983 because of anemia and a bleeding tendency. Hematological study revealed pancytopenia and leukoerythroblastosis. A bone marrow biopsy specimen showed a marked increase of reticulin-fibers and a focal proliferation of blasts. He showed no lymphadenopathy or hepatosplenomegaly at presentation. In the following 8 months, generalized lymphadenopathy and hepatosplenomegaly developed with progression of pancytopenia and an increase in the number of blasts in the peripheral blood.
In addition, he suffered from a high fever and generalized bone pain. In January 1984, he developed hypercalcemia and died. Serum parathyroid hormone and prostaglandin E levels were within normal limit at that time. Autopsy revealed a marked infiltration of blasts in the bone marrow, liver, spleen and lymph nodes. The blasts were positive for α-naphthyl acetate esterase, acid phosphatase and platelet membrane glycoprotein IIb/IIIa complex. Platelet peroxidase (PPO) activity, however, was weakly positive in only 5% of the blasts.
