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October 31, 1977

Diagnostic Terminology Disputed

JAMA. 1977;238(18):1914. doi:10.1001/jama.1977.03280190016015

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To the Editor.—  Garcia et al in their article "IgM in Skin Lesions of Systemic Amyloidosis" (237:1598, 1977) state that their patient had "aleukemic chronic lymphocytic leukemia." The patient had a WBC count of 9,100/cu mm with 30% lymphocytes in peripheral blood. Bone marrow showed an increase in lymphocytes with positive PAS staining.From this information they presented, I wonder how they can make the diagnosis of aleukemic chronic lymphocytic leukemia (CLL). The PAS positivity is hardly a specific characteristic for the CLL. In my opinion, they should have stated that the case had mild lymphocytosis of bone marrow and peripheral blood, rather than using the troublesome terminology of aleukemic CLL. This minor infraction, however, does not discredit their otherwise excellent presentation of a rare immune disorder.