Chronic neutrophilic leukemia(CNL) is a rare disorder characterized by persistent neutrophilia of mature cell type without evidence of infection, hepatosplenomegaly, elevated neutrophil alkaline phosphatase score and the absence of Philadelphia chromosome We report a typical case of CNL with multiple myeloma(IgG-lambda type) in 68 years old female. Many neutrophils had toxic granule and vacuole. The peripheral blood smear showed neutrophlic leukocytosis(50,940/microliter, neutrophil 94%) with rare immature form. The cytogenetic study showed normal karyotype without Philadelphia chromosome. She was diagnosed as multiple myeloma with paraproteinemia, lytic bone lesion of skull, and immature plasma cells in bone marrow.
Aged ; Alkaline Phosphatase ; Bone Marrow ; Cytogenetics ; Female ; Humans ; Karyotype ; Leukemia, Neutrophilic, Chronic* ; Multiple Myeloma* ; Neutrophils ; Paraproteinemias ; Philadelphia Chromosome ; Plasma Cells ; Skull ; Vacuoles