ISSN: 0022-1198
CODEN: JFSCA
Page Count: 5

Undiagnosed, Untreated Acute Lymphoblastic Leukemia Presenting as Suspected Child Abuse
Sandusky, GE
Senior pathologist, Lilly Research Laboratories, IN

McClain, JL
Fellow in forensic pathology and associate professor of pathology, Indiana University School of Medicine, IN

Clark, MA
Fellow in forensic pathology and associate professor of pathology, Indiana University School of Medicine, IN

(Received 22 May 1989; accepted 16 June 1989)

Abstract

Natural disease being mistaken for child abuse is rare. A two-year-old child was found unresponsive at home and transported to a local hospital, where she expired in the emergency room. Several cutaneous contusions were observed. Prior to the autopsy it was learned that an anonymous report of “child abuse” had been previously filed concerning this child. At autopsy there were multiple metasynchronous cutaneous contusions, but no radiologic or gross evidence of other injuries. A pericardial effusion, massive hepatosplenomegaly and generalized lymphadenopathy were apparent. The bone marrow, liver, spleen, lymph nodes, kidneys, pancreas, heart, stomach, and dura mater showed a monotonous lymphocytic infiltrate. Immunocytochemical studies confirmed the diagnosis of acute lymphoblastic leukemia of childhood. This case reaffirms the need for an objective examination of all cases by a forensic pathologist.

Keywords:
pathology and biology, child abuse, leukemia, acute lymphoblastic leukemia, monoclonal antibodies, autopsy

Paper ID: JFS12881J
DOI: 10.1520/JFS12881J
ASTM International is a member of CrossRef.