A 30 year old korean male was admitted to Korea University Hospital because of high
fever and diarrhea of one week duration. Physical examination discloses left axillary
lymphadenopathy and tepatomegaly. The patient was treated for typhoid fever with
chloramphenicol and antipyretics and discharged with some improvement of symptoms
after 4 days hospital stay.
He was readmitted after 10 days with general weakness, weight loss, dyspnea,
epistaxis and abdominal distension. Peripheral blood findings included pancytopenia with
2% atypical higtiocytes.
On the next day, bone marrow aspiration and left axillary lymph node biopsy were
done. However, his conditions deteriorated rapid1y and the patient expired on the third
day of the second admission. Autopsy was not performed.
The bone marrow smears revealed 14% atypical histiocytes, most of which engaged in
phagocytosis of erythrocytes, granulocytes, and platelets. The lymph node disclosed
preservation of nodal architectures with infiltrations of atypical histiocytes and their
precursors in the subcapsular and medullary sinuses. Phagocytosis of erythrocytes and
granulocgtes by more differentiated histiocytes was noted.
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