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Sudden death due to undiagnosed T lymphoblastic leukemia/lymphoma in a 5-year-old boy.

Publication ,  Journal Article
Stoecker, MM; Wang, E; Simmons, S
Published in: Am J Forensic Med Pathol
December 2012

Undiagnosed neoplasms in childhood are rare causes of sudden and unexpected death. Deaths due to undiagnosed hematologic malignancies are limited to a small number of case reports. The following case of acute leukemia was diagnosed at forensic autopsy in a 5-year-old boy with no significant past medical history. He complained of nausea and vomiting 2 days before his death, with the subsequent development of fever. Meningitis was the initial suspected cause of death. Findings at autopsy included a 100% cellular bone marrow with greater than 95% blasts. Hemorrhages involving the cerebrum, pons, epicardium, lungs, and thymus were present. Prominent leukemic infiltrates and leukostasis were present in the brain, heart, lungs, spleen, hilar lymph nodes, liver, and kidneys. A peripheral blood smear and automated blood cell count showed a white blood cell count of 435 × 10/L with greater than 80% circulating blasts. Immunohistochemical stains confirmed the diagnosis of T lymphoblastic leukemia/lymphoma. Given these circumstances, the diagnosis of acute leukemia should be considered when an intracerebral hemorrhage and/or visceral hemorrhages are identified on internal examination for appropriate collection of tissue for smears and microscopic examination. This case also highlights the uncommon, although serious, risks associated with acute lymphoblastic leukemia and hyperleukocytosis.

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Published In

Am J Forensic Med Pathol

DOI

EISSN

1533-404X

Publication Date

December 2012

Volume

33

Issue

4

Start / End Page

314 / 316

Location

United States

Related Subject Headings

  • Thymus Gland
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
  • Pons
  • Pericardium
  • Male
  • Lung
  • Leukocytosis
  • Legal & Forensic Medicine
  • Humans
  • Hemorrhage
 

Citation

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ICMJE
MLA
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Stoecker, M. M., Wang, E., & Simmons, S. (2012). Sudden death due to undiagnosed T lymphoblastic leukemia/lymphoma in a 5-year-old boy. Am J Forensic Med Pathol, 33(4), 314–316. https://doi.org/10.1097/PAF.0b013e31823d7d27
Stoecker, Maggie M., Endi Wang, and Samuel Simmons. “Sudden death due to undiagnosed T lymphoblastic leukemia/lymphoma in a 5-year-old boy.Am J Forensic Med Pathol 33, no. 4 (December 2012): 314–16. https://doi.org/10.1097/PAF.0b013e31823d7d27.
Stoecker MM, Wang E, Simmons S. Sudden death due to undiagnosed T lymphoblastic leukemia/lymphoma in a 5-year-old boy. Am J Forensic Med Pathol. 2012 Dec;33(4):314–6.
Stoecker, Maggie M., et al. “Sudden death due to undiagnosed T lymphoblastic leukemia/lymphoma in a 5-year-old boy.Am J Forensic Med Pathol, vol. 33, no. 4, Dec. 2012, pp. 314–16. Pubmed, doi:10.1097/PAF.0b013e31823d7d27.
Stoecker MM, Wang E, Simmons S. Sudden death due to undiagnosed T lymphoblastic leukemia/lymphoma in a 5-year-old boy. Am J Forensic Med Pathol. 2012 Dec;33(4):314–316.

Published In

Am J Forensic Med Pathol

DOI

EISSN

1533-404X

Publication Date

December 2012

Volume

33

Issue

4

Start / End Page

314 / 316

Location

United States

Related Subject Headings

  • Thymus Gland
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
  • Pons
  • Pericardium
  • Male
  • Lung
  • Leukocytosis
  • Legal & Forensic Medicine
  • Humans
  • Hemorrhage