非霍奇金淋巴瘤并发急性粒细胞白血病1例

1、患者血清LDH HBDH升高组与未升高组之间, G M2R表达水平并无显著差异,提示G M2R表达与肿瘤负荷指标关系不大。同样在AM L患者中,完成一个标准化疗时骨髓原始细胞下降指数50%和<50%两组间G M2R表达水平亦无显著性差异,即G M R2表达水平似与化疗近期疗效无关。总之,在测定急性白血病患者G M2R表达时,本组临床研究提示:AM L患者尤其是AM L2M5和AM L2M0亚型患者,G M2R表达水平较高,推测G M2R高表达有助于前述两亚型白血病的诊断与鉴别;且G M2R较高表达见于多数仅有髓系抗原阳性表达的AM L患者;同时还显示,G M2R表达水平与急性白血病肿瘤负

2、荷和化疗近期疗效似乎无关。参考文献1张日,冯一中,朱子玲,等.人粒巨噬细胞集落刺激因子受体在N I H3T3细胞中的功能表达J.中华血液学杂志,1999, 20(11:567-569.2L anza F,M o retti S,Papa S,et al.R epo rts on the F ifth Interna2ti onalW o rk shop on H um an L eukocyte D ifferentiati on A ntigen.Bo ston,1993J.H aem ato logica,1994,79:374-386.3W ognum A W,W esterm an Y

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9、Yoko ta T,et al.D ifferential exp ressi on ofgranulocyte2m acrophage co lony2sti m ulating facto r and I L23recep to r subunits on hum an CD+34cells and leukem ic cell linesJ.J A llergy C lin I mm uno l,1995,96:1083-1099.作者简介:谌登兵(1966-男,四川华莹人,1989年毕业于重庆医科大学医学系,1996年获医学硕士学位,现为苏州大学附属第一医院在读博士。非霍奇金淋巴瘤并发

10、急性粒细胞白血病1例陈跃琼关键词:非霍奇金淋巴瘤;急性粒细胞白血病;并发症中图分类号:R733.1;R733.71文献标识码:D文章编号:100929921(2003022*1病例介绍患者,女,30岁。2001年7月因左侧耳鸣、鼻塞进行性加重伴消瘦,在当地抗炎治疗稍减轻后加重,10月开始发现颈部肿块迅速增大增多,质偏硬,活动尚可。2001年10月22日到我院肿瘤科就诊,鼻咽部CT示:“鼻咽腔明显狭窄,顶壁结节状肿物突出,后壁及左侧壁均有侵犯,左隐窝消失,左鼻咽旁脂肪间隙肿物占据,左侧颈动脉靶饱满”。行鼻咽镜取活检考虑为“非霍奇金淋巴瘤”,为进一步检查住院。10月29日,鼻咽组织肿物活检:T细胞

11、性淋巴瘤。免疫组化:收稿日期:2002210208作者单位:广州市第十二人民医院,广东广州510620L CA(+,CD3(+,CK(-,CD79(-,CD56(-,L26(-,U CHL1(-,CYD1(-。骨髓穿刺:骨髓可见4.5%分类不明细胞,POX染色为强阳性。11月21日行第2次骨髓穿刺:原始粒细胞0.575,早幼粒细胞0.045,中性粒细胞0.025,晚幼粒细胞0.03,其中原始粒细胞体大小不等,细胞质蓝色,呈瘤突状、拖尾状或规则形,部分细胞质中有粉红色细小颗粒及空泡;核形规则或略有凹陷、切迹;核仁明显1个或多个;染色质呈细颗粒状;成熟粒细胞中毒颗粒明显,易见核棘突、空泡。红系增生低下,巨系增生正常,血小板量多,可见长条形血小板。细胞化学染色:POX强阳性;A KP阳性率100%,积324分。骨髓免疫分型:CD+13,CD+34,CD+15,CD13 CD7(+,CD34CD15(+。最后诊断:非霍奇金淋巴瘤(鼻型并发急性粒细胞白血病(M2。2讨论随着淋巴瘤治疗技术的发展,患者生存期明显延长,放化疗均可降低机体免疫功能,因此治疗后