The oral manifestations of leukemia were studied on a total of 148 autopsy cases. The case materials were obtained from the Department of Pathology, Tokoy Medical and Dental University. The cases were subclassified into acute myelogenous leukemia (AML, 47 cases), acute promyelocytic leukemia (AProL, 14 cases), acute monocytic leukemia (AMoL, 11 cases), acute lymphatic leukemia (ALL, 10 cases), chronic myelogenous leukemia (CML, 17 cases), acute leukemia (AL, 24 cases) and erythroleukemia (EL, 5 cases) . The results were as follows:
1. Gingival bleeding from the oral mucosa and the gingival swelling were frequently the initial symptoms of AML, AProL and AMoL. Twelve patients with AML (26%), seven with AProL (44%) and two with AMoL (18%) consulted the dentist first.
2. The other oral manifestations were oral ulcer, stomatitis, osteitis and disturbances of the cranial nerves.
3. Almost all patients with AProL had gingival bleeding and bleeding from the oral mucosa.
4. The patients with AMoL had gingival swelling more frequently than gingival bleeding, occasionally accompanied by a necrotizing lesion.
5. The patients with ALL, CML and AL showed oral symptoms only at times. 6. The gingival bleeding or bleeding from the oral mucosa occurred as a symptom of systemic hemorrhagic tendency. The presence of marginal periodontitis accelerated gingival bleeding. The gingival swelling, which was especially seen in AMoL, was caused mainly by leukemia cell infiltration. However, only the non-specific margial periodontitis was seen in some patients. The oral ulcer might be due to oral infection, sometimes caused by fungus. The inflammatory cell infiltration was seen occasionally.
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