Abstract
A 61-year-old man with marked eosinophilic leukocytosis who complained of gait disturbance and dementia was presented. The clinical studies and autopsy findings were compatible with eosinophilic leukemia.At autopsy, in addition to marked enlargement of the liver and spleen, there were slight enlargement of the lymph nodes. Marked eosinophilic infiltration of the bone marrow, liver, spleen and lymph nodes was observed by light microscope.Most of the eosinophils had mature type nuclei being sometimes hypersegmented, and intracytoplasmic vacuoles. Eosinophilic myelocyte and metamyelocyte were also found in the peripheral blood. Upon electron microscopic study of the eosinophile, the granules exhibiting various stages of development were observed in mature type eosinophil with multi-lobular nucleus. The eosinophile exhibited asynchronous maturation between the nucleus and cytoplasm.In addition to mural thrombus of both ventricles, there were multiple thrombosis of small arteries and arterioles. Consequently infarctions of the heart, spleen, brain and kedneys, and ulceration of the colon and small intestine occurred in this case. It is considered that both thromboembolism from the mural thrombus in the heart and disseminated intravascular coagulation due to eosinophilic leukemia may be the causes of the multiple thrombosis.
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