白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2014年
3期
163-165
,共3页
白血病,毛细胞%细胞形态学%免疫分型%透射电子显微镜
白血病,毛細胞%細胞形態學%免疫分型%透射電子顯微鏡
백혈병,모세포%세포형태학%면역분형%투사전자현미경
Leukemia,hairy-cell%Cell morphology%Flow cytometric analysis%Transmission electron microscope
目的 探讨变异型毛细胞白血病(HCL-V)的临床特点、诊断及鉴别诊断.方法 回顾分析1例HCL-V患者的临床特点,行外周血涂片、骨髓细胞学、免疫分型及透射电子显微镜检测,并复习相关文献.结果 该患者脾脏大20余年,有反复肺部感染病史,血常规示白细胞计数及淋巴细胞比例异常增高,外周血涂片及骨髓细胞学检查均可见淋巴细胞比例明显增高,部分淋巴细胞胞体边缘不整齐,核仁明显,有不规则绒毛状突起.免疫分型:淋巴细胞约占有核细胞的53.0％,其中CD19+细胞约占有核细胞的33.7％,表达CD11c、CD19、CD20、CD22,部分细胞表达FMC-7、CD103、Lambda,不表达CD5、CD23和CD25.外周血透射电子显微镜观察多见绒毛状单个核细胞.结论 HCL-V是一种罕见的B细胞肿瘤性疾病,诊断较为困难,需要与经典毛细胞白血病和脾边缘区B细胞淋巴瘤等其他疾病相鉴别,通过细胞形态学、免疫分型、透射电子显微镜及临床特点可明确诊断.
目的 探討變異型毛細胞白血病(HCL-V)的臨床特點、診斷及鑒彆診斷.方法 迴顧分析1例HCL-V患者的臨床特點,行外週血塗片、骨髓細胞學、免疫分型及透射電子顯微鏡檢測,併複習相關文獻.結果 該患者脾髒大20餘年,有反複肺部感染病史,血常規示白細胞計數及淋巴細胞比例異常增高,外週血塗片及骨髓細胞學檢查均可見淋巴細胞比例明顯增高,部分淋巴細胞胞體邊緣不整齊,覈仁明顯,有不規則絨毛狀突起.免疫分型:淋巴細胞約佔有覈細胞的53.0％,其中CD19+細胞約佔有覈細胞的33.7％,錶達CD11c、CD19、CD20、CD22,部分細胞錶達FMC-7、CD103、Lambda,不錶達CD5、CD23和CD25.外週血透射電子顯微鏡觀察多見絨毛狀單箇覈細胞.結論 HCL-V是一種罕見的B細胞腫瘤性疾病,診斷較為睏難,需要與經典毛細胞白血病和脾邊緣區B細胞淋巴瘤等其他疾病相鑒彆,通過細胞形態學、免疫分型、透射電子顯微鏡及臨床特點可明確診斷.
목적 탐토변이형모세포백혈병(HCL-V)적림상특점、진단급감별진단.방법 회고분석1례HCL-V환자적림상특점,행외주혈도편、골수세포학、면역분형급투사전자현미경검측,병복습상관문헌.결과 해환자비장대20여년,유반복폐부감염병사,혈상규시백세포계수급림파세포비례이상증고,외주혈도편급골수세포학검사균가견림파세포비례명현증고,부분림파세포포체변연불정제,핵인명현,유불규칙융모상돌기.면역분형:림파세포약점유핵세포적53.0％,기중CD19+세포약점유핵세포적33.7％,표체CD11c、CD19、CD20、CD22,부분세포표체FMC-7、CD103、Lambda,불표체CD5、CD23화CD25.외주혈투사전자현미경관찰다견융모상단개핵세포.결론 HCL-V시일충한견적B세포종류성질병,진단교위곤난,수요여경전모세포백혈병화비변연구B세포림파류등기타질병상감별,통과세포형태학、면역분형、투사전자현미경급림상특점가명학진단.
Objective To study the clinical features and differential diagnosis of hairy-cell leukemia variant (HCL-V).Methods A case with HCL-V was reported and the literatures were reviewed.Results The patient had splenomegaly for twenty years and a history of recurrent pulmonary infection.His blood routine test showed a high white blood cell count and abnormal high proportion of lymphocytes.Peripheral smear and bone marrow smear both showed significantly higher proportion of lymphocytes,part of which had soma jagged,prominent nucleoli and villous/hairy cytoplasmic projections.His hairy leukemic cells expressed CD1 1c,CD19,CD20,CD22,and had variable expression of FMC-7,CD103 and lambda,but not CD5,CD23 and CD25.Transmission electron microscope showed many monocytes with villous exist in peripheral blood.Conclusions HCL-V is a rare and an indolent form of a small,mature,B-cell leukemia,based on the clinical,peripheral smear,bone marrow smear,flow cytometric analysis and transmission electron microscopy features,a diagnosis of HCL-V is confirmed.The differential diagnosis should always include splenic marginal zone B-cell lymphoma and HCL-C,because they have different clinical and biological features.
