[Hematoma in acute leukemia--suspected diagnosis of child abuse]

A 4-year-old child, suspected of being the victim of child abuse was sent for forensic examination. The examination established multiple, uncharacteristically shaped haematomata in various parts of the body. In addition, petechiae were also present. In view of the nature and localisation of the haematomata and the presence of petechial bleeding a differential diagnosis considered the possibility of a haematological disease and clinical paediatric tests were done to establish the cause, which showed an acute lymphatic leukaemia (ALL) with thrombo(cyto)penia. As haematomata are often the first indication of a leucosis, whenever child abuse is suspected, this possibility should also be considered.