Reticulum-cell sarcoma in infancy.

In August, 1948, at the age of 1 year, this baby girl was admitted to the surgical wards of the Royal Hospital for Sick Children, Glasgow, with a red, hot and painful swelling of the left leg of 10 days' duration. The temperature was 1010 F. and the white blood count 8,000. A diagnosis of haematogenous osteitis was made, the limb was immobilized, and, after removing venous blood for culture, penicillin therapy was started. Radiography the following day revealed an area of decalcification in the upper tibial metaphysis (Fig. 1), and the bacteriologist reported a pure growth of coagulase-positive Staphylococcus aureus from the blood culture. Within three days the temperature was normal and the leg painless. Aspiration of soft tissue and bone marrow revealed neither pus cells nor organisms. FIG. 1.-On the day following admisRadiography three sion an antero-posterior radiograph weeks after admission shows an area of decalcification in the upper tibial metaphysis (August, 1948). revealed separation of the upper tibia and fibula, more suggestive of tumour than of infection(Fig. 2). Abiopsy was performedthe following