This patient’s total leukocyte count was 96.2 x
10,000
mm
3
mm
3
size 12{ ital "mm" rSup { size
8{3} } } {}
with 12% lymphocytes, 38% monocytes, and 50% blasts. His bone
marrow study confirmed the diagnosis.
Major infiltration of the gums by leukemic cells is
common in acute myelomonocytic or monocytic leukemia and may be the presenting
manifestation. This feature is less frequent in other types of acute
leukemia.
Noticeable gingival hypertrophy may also result
from several drugs (phenytoin, cyclosporine, nifedipine, diltiazem, verapamil
and penicillamine), and from various maladies (scurvy, sarcoidosis, Crohn’s
disease, amyloidosis, lymphoma, Kaposi’s sarcoma, cytomegalovirus infection,
Wegener’s granulomatosis, and hereditary gingival fibromatosis).