A 19 year old Korean army officer was transferred from aeromedical center, ROKAF
to Seoul National University Hospital with high, intermittant fever, severe pitting edema,
jaundice, epistasis and anemia.
The patient had been debilitated rapidly during the three months of hospitalization and
terminated without definite diagnosis.
Two times of bone marrow aspirations and liver necropsy were performed.
Peripheral blood examinations revealed severe anemia (Hb. 2.5-9.5 ㎎%), leukopenia
(600-6800) with relative lymphocytosis (65%) and a few atypical foamy
histiocytes(2-5%).
First bone marrow aspiration revealed marked hypocellularity, relative lymphocytosis
and occasionally found histiocytes with vacuolation and erythrophagocytosis.
Liver necropsy showed proliferation of Kupffer cells and atypical histiocytic cells with
active erythrophagocytosis, intrahepatic cholestasis and focal pylephlebitis.
Second bone marrow, relatively hypocellular, differed from the first and showed
marked proliferation of monocytic series (monoblast 38%, immature monocyte 15%,
monocytes 3%).
These abnormal monocytic cells had deep grey-blue cytoplas:n with small vacuoles
and pinkish granules and relatively large round to ovoid nuclei, most of which had one
to two prominent nucleoli and coarse chromatin pattern.
Some of these monocytic cells are resemble to atypical foamy histiocytes of the first
bone marrow.
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