A case of atypical myeloid leukæmia with nodular infiltration of the skin / by H.D. Rolleston, M.D., F.R.C.P., ... and Wilfrid Fox, M.D., M.R.C.P.

  • Rolleston, Humphry Davy, Sir, 1862-1944
Date:
[1909]
Catalogue details

Licence: In copyright

Credit: A case of atypical myeloid leukæmia with nodular infiltration of the skin / by H.D. Rolleston, M.D., F.R.C.P., ... and Wilfrid Fox, M.D., M.R.C.P. Source: Wellcome Collection.

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    morphonuclears, 48 per cent.; lymphocytes, 48 per cent. (44 per cent, large and 4 per cent, small); eosinophiles, 2 per cent.; mast-cells, 05 per cent. ; myelocytes, 1*5 per cent. One normoblast was seen in a count of 100 white cells. The patient was, however, sent to the Atkinson-Morley Convalescent Hospital at Wimbledon, where she remained until May 13th, when she was readmitted into the hospital. The improvement had not continued while at the convalescent hospital, the patient being rather worse in her general condition than when she went away. In addition there was a large sub-periosteal swelling on the right tibia occupying about two thirds of the anterior border; this did not appear to be haemor¬ rhagic, and was extremely tender to touch. The abdominal skin nodules were fainter in colour but there were manv more out on the *y lower limbs, and those on the thighs had a definite greenish colour. On May 14th a blood examination showed : Red cells, 2,445,000“; white cells, 98,400. Differential leucocyte-count: Polymorphonuclears, 59 per cent.; lymphocytes, 24 per cent. (22 per cent, large and 2 per cent, small) ; mononuclears, 2 per cent. ; transitionals, 5 per cent.; eosinophiles, 1 per cent.; myelocytes, 9 per cent.; mast-cells, nil. One normoblast was seen in a count of 100 white corpuscles. The swelling on the right tibia gradually went down, and on May 20th it was no longer tender; it did not leave any bruising as it disappeared. On May 21st the patient said she felt better, and, at her own request, went to her own home in Pimlico, and could not be persuaded to return to the hospital again. While she was in the hospital the temperature during the first week showed a slight regular evening elevation (100° F.), being normal in the morning. It then became rather more irregular, and on April 8th reached 101*5° F., which was the highest observed; from that date until she was discharged it was never above 100° F. The urine usually contained crystals of uric acid, and once a trace of albumin, but there was never any hsematuria. Letters asking her to come up to the hospital for inspection not meeting with success, on August 17th one of us visited her in her home. She was feeling much better and going about a little, but quickly got tired and out of breath on any exertion. The skin-nodules on the trunk were unchanged, but a large one had appeared for the first time on the face, occupying the outer half of the right eyelid.