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April 2, 1982

Atypical Monocytes in a Patient With Hodgkin's Disease

Author Affiliations

From the Hematology-Oncology Service (Drs Butler, Taylor, and Hurwitz), and the Department of Medicine (Dr Birx), Walter Reed Army Medical Center, Washington, DC. Dr Butler is currently with the University of South Carolina School of Medicine, Columbia.

JAMA. 1982;247(13):1862-1863. doi:10.1001/jama.1982.03320380054030

ATYPICAL monocytes and Sternberg-Reed cells have been described in leukocyte concentrations of peripheral blood in patients with Hodgkin's disease.1 The atypical monocytes were either large with irregular nuclei or large with numerous vacuoles. Using similar leukocyte concentration techniques, Hoerni and co-workers2 demonstrated Sternberg-Reed cells or atypical monocytes during nine of 19 pyrexic episodes in 24 patients with Hodgkin's disease. However, only one of 27 samples collected during periods without pyrexia contained abnormal cells.2

We have recently seen a patient with periodic fevers of nearly 12 months' duration. Large vacuolated monocytic cells were seen in routine peripheral blood films during episodes of pyrexia. These monocytes closely resembled the atypical monocytes that have been described in leukocyte concentrations of patients with Hodgkin's disease. Our patient was found to have Hodgkin's disease after a lengthy evaluation.

Report of a Case  A 41-year-old man had a 12-month history of recurrent fevers,