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September 1974

Extramedullary Myeloblastic Transformation of Chronic Myelocytic Leukemia: Lymph Node Infiltration One Year Before Marrow Blastic Change

Author Affiliations

From the departments of medicine (Drs. Woodson and Sears) and pathology (Dr. Bennett), University of Texas Medical School at San Antonio.

Arch Intern Med. 1974;134(3):523-526. doi:10.1001/archinte.1974.00320210133020

Enlargement of lymph nodes is uncommon in chronic myelocytic leukemia (CML). Generalized lymphadenopathy may occur in association with the conversion of the leukemia to a morphologically acute form (blastic transformation) due to infiltration into or proliferation within nodes of immature myelocytic cells (myeloblasts). In a few cases such involvement of lymph nodes has preceded overt blastic transformation in bone marrow and blood.1-4 The following case report describes a patient in whom myeloblastic infiltration of a single lymph node was demonstrated one year before blastic transformation of the bone marrow.

Patient Summary  A 13-year-old black girl was admitted to another hospital in February 1965, with a three-month history of intermittent painful swelling of the knees. Her spleen was palpable 8 cm below the left costal margin. There was no hepatomegaly or lymphadenopathy, and results of the remainder of the physical examination were normal. Laboratory values included the following: hematocrit, 37%;

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