Yoshida K, Kusumoto S, Sugahara Y, Yagasaki F, Sakata T, Kawai N, Matsuda A, Suzuki T, Hirashima K, Kayano H, Bessho M
First Department of Internal Medicine, Saitama Medical School.
Rinsho Ketsueki. 2001 Aug;42(8):644-9.
A 41-year-old man visited his doctor in May 2000 because of a sore throat and high fever. His symptoms did not improve, despite administration of antibiotics and nonsteroidal anti-inflammatory drugs. Since a chest X-ray examination revealed an anterior mediastinal bulky tumor, he was referred and admitted to our hospital on June 21, 2000. The peripheral white blood cell count was 44,540/microliter with 74% myeloblasts. Bone marrow aspiration revealed a hypercellular marrow with 82% myeloblasts, which were negative for peroxidase and alpha-naphthyl butylate esterase staining. Blast cells were positive for CD7, CD13, CD33, CD34, and HLA-DR, and negative for CD56. A needle biopsy specimen of the mediastinal tumor consisted of myeloblasts. We diagnosed the patient as having CD7 (+) acute myeloid leukemia (AML) (M0) with a bulky mediastinal mass based on the surface marker analysis, although the clinical features resembled myeloid/NK precursor acute leukemia. The patient achieved a complete remission after two courses of induction therapy. We are planning an allogeneic stem cell transplantation during his first remission because of the high risk of relapse.
一名41岁男性因喉咙痛和高烧于2000年5月就医。尽管使用了抗生素和非甾体抗炎药，他的症状仍未改善。由于胸部X光检查发现前纵隔有一个巨大肿瘤，他于2000年6月21日被转诊并入住我院。外周血白细胞计数为44,540/微升，其中原始粒细胞占74%。骨髓穿刺显示骨髓细胞增多，原始粒细胞占82%，过氧化物酶和α-萘丁酸酯酶染色均为阴性。原始细胞CD7、CD13、CD33、CD34和HLA-DR呈阳性，CD56呈阴性。纵隔肿瘤的针吸活检标本由原始粒细胞组成。根据表面标志物分析，我们诊断该患者患有CD7(+)急性髓系白血病（AML）（M0）伴巨大纵隔肿块，尽管其临床特征类似于髓系/NK前体急性白血病。该患者在两个疗程的诱导治疗后达到完全缓解。由于复发风险高，我们计划在他首次缓解期间进行异基因干细胞移植。
