A case of malignant lymphoma of lymphoblastic type associated with marked
eosinophilia is presented. The patient, a 57 years old male, had been noticed a gradually
growing mass .on his left upper quadrant of abdomen without other specific complaints
for one year.
On Nov. 26, 1966 he had splenectomy under the diagnosis of portal hypertension.
Peripheral blood before and after the splenectomy revealed anemia (hemoglobin: 9.0-11.0
gm/dl), leukocytosis (18,700-51,600/㎣) and marked eosinophilia (54-91%).
Pathological findings of the spleen, liver and mesenteric lymphnodes at the time of
splenectomy revealed marked splenomegaly (2,000gm.) with extramedullary hematopoiesis
and massive eosinophilic infiltrations.
Bone marrow findings on 13 days after splenectomy also revealed marked proliferation
(ME vol. 11%) and eosinophilia (eosinophilic promyelo. 3%, eosinophilic myelo. 6%,
eosinophilic metamyelo. 11%, mature eosinophil 34%).
After splenectomy, the patient was relatively well being status for about 6 months
until he started to suffer from generalized malaise. Just before the second admission %
SNU Hospital on August 31, 1967, the patient, after taking some herb medicine, had
generalized erythematous macules with fever and sore throat. Physical examination on
admission revealed a moderate degree of lymph node enlargement on left neck, both
inguinal region and axilla in addition to skin eruption.
Pathological diagnosis of three lymphnodes from neck was malignant lymphoma of
probably lymphoblastic type without eosinophil infiltration. Skin eruption was diagnosed
as a drug eruption by dermatologists. During 17 days of second hospitalization,
leukocyte counts were fluctuated from 13,400 to 32,500/㎣ with eosinophil counts from
62% to 85%. Liver function test reveals reversed A/G ratio (0.6) and elevated T.T.T
(6.4units).
During this admission, he was treated with prednisolone (40 mg. to 50mg./day) and
other conservative measurement, but was not improved much. The patient discharged
from SNU Hospital but readmitted to the NMC. on Sept. 21, 1967. Skin biopsy was
done arid diagnosed as erythema multiforme. At the NMC, the patient was treated with
endoxan and leukeran which resulted in decreased W. B. C. count (up to 6,150/㎣)
During the hospitalization for one month, his contrition did not improved in spite of
intensive care, and discharged on Oct. 26, 1967. He was died 2 months later.
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