부산대학교 도서관

A 62-year-old housewife was admitted on September 1975, because of fatigue, palpitation and shortness of breath. Physical examination demonstrated anemia, but there was no hepatosplenomegaly and superficial lymphadenopathy. Peripheral blood showed moderate anemia, thrombocytopenia and no atypical cells, however, atypical cells of 4.5% was observed in bone marrow specimen. These cells were positive for peroxidase and SBB stain and nucleolus staining showed M-type. From these results, the diagnosis of acute myeloblastic leukemia was made. Chromosome study of the marrow cells revealed karyotype [46xx, 5q-]. In November, she complained of a nasal obstruction, and as its cause a tumor was found at the middle nasal meatus. Biopsy specimen from this tumor revealed welldifferentiated hemangioma. And anti-EBV antibodies titer was examined at this time, her serum showed high value, anti-VCA was 1: 1280, anti-EA was 1: 80, respectively.Through all clinical course, anti-VCA and anti-EA persisted at high level of 1: 640 and 1: 320, respectively.After the appearance of nasal tumor, leukemic cells increased in peripheral blood and bone marrow, and a marked hepatosplenomegaly developed. In spite of combined chemotherapy, she died on February 21, 1976.On autopsy, leukemic cell proliferation and infiltration were noted in bone marrow, liver and spleen.Case report of AML with high anti-EBV titer is rare. A relationship between AML and EBV infection in the present case was discussed.