Original Clinical Diagnosis Research Articles

Monocytic leukemia. Clinically appearing as 'malignant reticulosis of the skin'

Enzyme cytochemical (hydrolytic enzymes for cell differentiation), immunocytologic (B and T lymphocyte differentiation), and electron microscopic studies of skin infiltrates facilitate the proper diagnosis of myelomonocytic and lymphoreticular proliferations. With use of these methods, the original clinical diagnosis of malignant reticulosis of the skin was corrected to monocytic leukemia in a 65-year-old woman. Because primary involvement of the skin preceded monocytosis of the blood, it was concluded that the cutaneous infiltrates in our patient resulted from proliferation of tumor cells in the skin rather than from homing of the cells to, or settling of the cells in, the skin.

Monocytic Leukemia

Enzyme cytochemical (hydrolytic enzymes for cell differentiation), immunocytologic (B and T lymphocyte differentiation), and electron microscopic studies of skin infiltrates facilitate the proper diagnosis of myelomonocytic and lymphoreticular proliferations. With use of these methods, the original clinical diagnosis of malignant reticulosis of the skin was corrected to monocytic leukemia in a 65-year-old woman. Because primary involvement of the skin preceded monocytosis of the blood, it was concluded that the cutaneous infiltrates in our patient resulted from proliferation of tumor cells in the skin rather than from homing of the cells to, or settling of the cells in, the skin.

Collagen diseases in children; problem of diagnosis.

The majority of cases of collagen disorders can be diagnosed by careful evaluation of the entire clinical picture, including properly selected laboratory tests. However, on occasion, new developments in the course of the patient's illness may make it necessary to alter the original clinical diagnosis. Rarely, multiple diagnoses must be made when unmistakable features of more than one collagen disease appear in the same individual.Although rheumatic fever is more common in childhood, the other disorders in this group are not so rare that they may be disregarded in differential diagnosis. Before a final diagnosis of rheumatic fever is made in any case, proper consideration should be given to the possibility that the patient's symptomatology is caused by one of the other collagen disorders.