Abstract
Acute leukemia was diagnosed in apreviously healthy boy, during a febrile respiratory infection. The clinical findings were fever and residua of a pneumonia The liver was slightly enlarged. Skin and mucous membranes were unaffected and there was no lymphadenopathy.
The leucocyte count was 49.7 × 109/1, with 68% blasts. The same blast cells infiltrated the bone marrow almost completely. The MGG-stained blasts resembled mature monocytes, with slightly basophilic cytoplasm. The nuclei were mostly lobulated or irregular, ond contained 0-2 nucleoli. Some binucleated cells were seen. The cells were not stained with Sudan B, but they contained fine PAS-positive granules and were strongly positive for α-naphtyl acetate esterase. Auer rods were not seen and the few myeloid cells in the peripheral blood were strongly alkaline phosphatase positive. The lysozyme concentration in urine was enormously elevated to 800-1.000 μg/ml.
The leucemic cells did not form rosettes with sheep RBC ond were negative for surface bound IgG. About 70% of the blasts formed rosettes with IgG coated human RBC, which indicates a high density of membrane Fc-receptors.
The karyotype of bone morrow cells was 44, ×, -15, -21, +mar, del (2) (p11). The missing Y chromosome could be demonstrated in the marker chromosome. The karyotype of peripheral blood lymphocytes was normal, 46, XY. The morphology of the cells, the histochemistry and membrane Fc-receptors all indicate that the blasts belong to the monocytic series. Pure monocytfc leukemia in childhood is extremely rare and detailed case reports including chromosomal abnormalities are scarce.
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Wegelius, R., Weber, T., Salmenperä, L. et al. PURE MONOCYTIC LEUKEMIA IN A 9 YEAR OLD BOY. Pediatr Res 12, 73 (1978). https://doi.org/10.1203/00006450-197801000-00078
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DOI: https://doi.org/10.1203/00006450-197801000-00078