Blast crisis of Ph1-CML, with the prevalent features of malignant histiocytosis.

Correspondence: Prof. Lino Piccinini, Divisione di Oncologia Medica, Policlinico, via del Pozzo 71, 41100 Modena, Italy. Phone international +39-59-422230 • Fax: international +39-59424549. In hematology, morphological features (such as the May-Grünwald-Gimsa stain) often provide useful diagnostic indications which can then be complemented with cytochemical and/or immunological data, depending on the situation. Research into the histological archives sometimes brings to light cytological findings of considerable interest, as in the present study. The case in question is on file in our historical archives and dates back to 1978. This accounts for the fact that no immunohistochemical or molecular cytogenetic tests were carried out. The traditional cytochemical tests included: Sudan black B, PAS, myeloperoxidase, acid phosphatase, naphthol AS-D acetate esterase, naphthol AS-D chloroacetate esterase, alpha napthyl butyrate esterase. A 49-year old female with a history of Ph1-positive chronic myeloid leukemia (Ph1-CML) was admitted to our Institute in October 1978 having a pale coloring, petechiae of the mucosa and widespread ecchymoses. The patient was not feverish and showed no signs of adenomegaly or hepatosplenomegaly. Hematological findings were as follows: Hb 10.7 g/dL, platelet count 163109/L, WBC 83109/L, with neutrophils 52%, lymphocytes 20%, monocytes 3%, blasts 18%, myelocytes 5%, metamyelocytes 2%, nucleated red blood cells 24% WBC.