Monocytic leukemia is an entity that has engendered a variety of divergent clinical and histologic opinions. A case is presented in which prolonged and intensive clinical and laboratory observations demonstrate the erratic course of this disease and illustrate the erroneous conclusions that may be derived from inconstant, momentary observations of this dynamic process. Study of the "natural history" of monocytic leukemia yields observations which tend to reconcile many of the hitherto conflicting opinions regarding this disease.

The origin and characteristics of the monocytic cell are discussed, and its probable derivation from mesenchyma is emphasized.

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