JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 54 No. 3       2008

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Aplastic anemia is a blood disease characterized by pancytopenia due to a decrease in hematopoietic stem cells. We describe a patient who presented with submucosal hematoma of the tongue and was given a diagnosis of aplastic anemia. The patient was a 24-year-old man who visited our department because of a hematoma of the tongue. Two days before presentation, a dark reddish tumor with a diameter of 1-2 mm was noticed at the left margin of the tongue. At presentation, a 20 X 11 mm dark reddish elevation was seen at the left lateral margin of the tongue. On the basis of the above course and findings, a hematoma was diagnosed, and blood tesis were conducted. A blood disease was suspected. The white blood cell count was 500/Μ 1, the red blood cell count was 320 X 104/Μ 1, the Hb was 11.2g/dl, the Ht was 31.1 %, the MCV was 96.9 fl, the MCH was 35.0 pg, the MCHC was 36.1 %, and the platelet count was 0.3 X 104/Μ 1, indicating pancytopenia. A submucosal hematoma of the tongue accompanied by pancytopenia was diagnosed, and detailed examinations were performed al the hematology department. A bone marrow puncture test showed that the bone marrow cell count was 4,000/Μ 1 and the megakaryocyte count was 0/Μ1; aplastic anemia was thus diagnosed, and the patient received immunosuppressive therapy. Even when the onset is gradual, aplastic anemia can be lethal if detection is late and appropriate therapy is not administered. Therefore, if the regional cause of an oral hematoma is not clear, close follow-up is necessary. If systemic factors are suspected, blood tests should be promptly performed. Key words: aplastic anemia, tongue, hematoma.

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