In 1908 Donhauser1 reported the occurrence in a man aged 58 of a greatiy enlarged spleen attended by secondary anemia. At necropsy, in addition to myeloid metaplasia of the spleen, the bone marrow was sclerotic. Except for the fact that neither abnormal white cells nor nucleated red cells were present in the blood stream, Donhauser's case is a replica of the disease which has since been described by the Italians as "erythremic myelosis" and in this country as "agnogenic myeloid metaplasia of the spleen" by Jackson, Parker and Lemon.2 Clinically the condition is characterized by weakness, joint pains, epistaxis and loss of weight, occasionally by jaundice, by slowly progressive enlargement of the spleen and by immature red and white cells in the blood stream.
It is generally agreed that agnogenic myeloid metaplasia of the spleen is an entity, although there are two views concerning its nature. According to