Undiagnosed, Untreated Acute Lymphoblastic Leukemia Presenting as Suspected Child Abuse
McClain, JL
Fellow in forensic pathology and associate professor of pathology, respectively, Indiana UniversitySchool of Medicine, Indianapolis, IN.

Clark, MA
Fellow in forensic pathology and associate professor of pathology, respectively, Indiana UniversitySchool of Medicine, Indianapolis, IN.

Sandusky, GE
Senior pathologist, Lilly Research Laboratories, Greenfield, IN.


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

Paper ID: JFS353900735

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Author McClain JL, Clark MA, Sandusky GE Title Undiagnosed, Untreated Acute Lymphoblastic Leukemia Presenting as Suspected Child Abuse Symposium , Committee on