集団検診により極めて早期に発見せる原爆被爆者白血病の1例
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概要
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One myelocytic leukemia was found as the result of hematological examinations which were performed on about 7000 persons who were exposed to the A-bomb within 2000m from the hypocenter. The patient was exposed to the A-bomb at a distance of 1200m when he was 2 years old. He had no major radiation symptoms and had been feeling well for the past 10 years. The patient was admitted to the hospital on 16-oct.-54. For observation, Anemia was not noticed, but the wbc increased to 47000 on 26-Oct. and the blood picture showed 13.5% promyelocytes, 1.0% myelocytes and 10.0% metamyelocytes in the neutrophilic series but no myeloblasts were seen. It was also noticed that the basophilic count was 5.5%. The bone-marrow showed 1.2% myeloblasts and 41.4%, promyeloffasts 8.0% myelocytes, 21.6% metamyelocytes, 12.6% stabs and 6.8% segs in the neutrophilic series. The incidence of juvenile cells was high; the lymphocyte count was 0.8%. The blood picture was that of myelocytic leukemia although the incidence of the myeloblasts was low. The spleen was palpable 1/2 finger breadths belon left costal margin and was of moderate consistency. The wbc showed a tendency to increase after admission and Nitromin was injected in a gradually increasing dosage to a total amount of 240mg. and was finally stopped because of the sudden decrease in the wbc and the juvenile cells. The patient still had no complaints and the wbc and the promyelocytes were arrested at the level of 10000 and 3-4% respectively. This case is of interest because of its being found in early stege in an A-bomb exposed person. The problem as to whether this is an acute or a chronic leukemia, and the increase of basophils must be followed in the future.
- 社団法人 日本内科学会の論文