Hypereosinophilia.

摘要

A 52-year-old woman presented to the hematologist with marked leukocytosis. She had a history of rash, weight loss, fevers, and lethargy for several months. There had been no foreign travel, use of drugs, gastrointestinal problems, joint disease, or pulmonary complaints. Physical findings included a macular and erythematous rash, pallor, clear lungs, mild hepatomegaly, moderate enlargement of the spleen, and slight adenopathy. Laboratory findings included a white cell count of 144 X 10~9/L of which 60% were eosinophils. Other results included a hemoglobin of 102 g/L, platelets of 106 X 10~9/L, normal renal function, and mild liver function abnormalities. A peripheral blood smear showed the prominence of eosinophilia. However, a population of atypical lymphoid cells was also present, many of which had lobulated nuclear form. The bone marrow was markedly hypercellular with abundant eosinophils in all stages of maturation. Occasional collections of lymphoid forms were noted similar to those seen on the peripheral smear. Lymph node and liver biopsies were performed and a diagnosis of mycosis fungoides was made. The peripheral blood lymphoid cells were considered as Sezary cells.