Lymphocytic leukemoid reaction of the blood associated with miliary tuberculosis.

By FRANK H. GARDNER, M.D., AND STACY R. METTIER, M.D. B LOOD pictures similar to those of myelocytic and lymphocytic leukemia have been reported’6 to occur not infrequently in patients with miliary tuberculosis. These reports indicate that there is a marked ‘ ‘shift to the left’ ‘ of the leukocytes in the peripheral blood to include varying percentages of myelocytes and myeloblasts. This hemogram is associated with an absence of the characteristic leukemic infiltration of the tissues on postmortem examination. Landon’ has reported a case of tuberculous bronchopneumonia in a i6 year old girl in whom the white blood cell count rose to 36,800 per cubic millimeter of blood; 95 per cent of the cells were considered to be immature lymphocytes. Coley and Ewing8 ‘ 8 reported the case history of a 42. year old woman with diffuse tuberculosis of the lymph nodes. The white blood cell count was 8,ooo cells per cubic millimeter of blood, of which 84 per cent were reported as of the ‘ ‘mononuclear’ ‘ type. The mononuclear cells were considered to be lymphocytes. The