Extramedullary Myeloblastic Transformation of Chronic Myelocytic Leukemia

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Abstract
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%;