An autopsy case of a 33 years old doctor with chronic lymphocytic leukemia (CLL) was reported. Two remissions were noted with chemotherapy and irradiation. The special characteristic of this case was the tumor formation in the sellar fossa similating a pituitary tumor which was considered a s a type of meningeal leukemia, showing visual disturbance. Leukemic cell infiltration was hardly observed in any other organs.From the analysis of five cases of CLL, the author proposes that CLL may be classified into two types: the one is the severe type showing a short clinical course and the other is a mild one, showing a long clinical course. Details such as histopathological findings, cause of death and clinical findings were discussed. ACTA PATH. JAP. 28: 7 9 7~8 0 5 , 1978.Chronic lymphocytic leukemia (CLL) is a rare disease in our country1, and only a few pathomorphological reports are found. CLL affects those in the higher age bracket, and shows marked lymphadenopathy, hepatosplenomegaly and leucocytosis. The leukemic cells are characterized by small mature lymphocytes and the clinical course is usually long, in spite of extensive invasion into the general organs.The present case was characteristic in that he presented the symptom and signs of pituitary tumor which were actually accompanied by a cherry-sized pituitary mass a t r a t e d with leukemic cells.
Clinical HistoryA 33 years old doctor visited the hospital on August, 1969, with symptoms of general fatigue and purpuric eruptions of both lower limbs. He was pointed out that the spleen was palpable one finger-breadths below the lei% costal margin. Examination of peripheral blood; RBC 382x1O4/cmm, WBC 144xlOS/cmm with 97.4% of small mature lymphocytes, and platelets 6.2 x 104/cmm. Soon after his symptoms disappeared spontaneously.In his past history, he had rheumatic fever at the age of 16 years. &$ 5 8 k A $333 E:ari 797 798 OLL WITH MASSIVE INVASION IN PITmThRY Aota Pdh. Jap.