Association of T cell acute lymphoblastic leukemia and histiocytic medullary reticulosis.

Seventeen reported cases of acute lymphoblastic leukemia that terminated in a clinical picture of histiocytic medullary reticulosis were reviewed. Using the presence of T cell markers, mediastinal mass, or very high initial white blood cell count as suggestive of T cell acute lymphoblastic leukemia, nine of 13 evaluable cases fulfilled such criteria. This review raises the possibility that the histiocytic medullary reticulosis appearing in the course of T cell acute lymphoblastic leukemia is the result of lymphokine production by the leukemic cells.