Ozaki S, Kawachi Y, Igaki T, Ogasawara N, Uchida T, Mori M, Setsu S, Machii T
Department of Internal Medicine, Takamatsu Red Cross Hospital.
Rinsho Ketsueki. 1992 Jun;33(6):817-22.
A 54-year-old man who had been known to have a high prolymphocyte count for four years was admitted to our hospital because of dyspnea in September, 1990. Physical examination revealed skin eruption, lymphadenopathy and hepatosplenomegaly. Chest X-ray demonstrated bilateral pleural effusions. The leukocyte count was 232,900/microliter with 99% lymphoid cells possessing single nucleoli. The cells expressed the phenotype CD2+, CD3-, CD4+, CD7+, and CD8-. Southern blot analysis of DNA from these cells revealed monoclonal rearrangement of T-cell receptor beta-chain genes. Anti-human T-cell lymphotropic virus type 1 (HTLV-1) antibody and HTLV-1 proviral DNA were not detected. A biopsy specimen from the skin lesions showed infiltration of the leukemic cells which were positive for anti-MT1 antibody. Histological finding of the axillary lymph node was malignant lymphoma, diffuse, medium-sized, T-cell type. Combination chemotherapy resulted in the improvement of skin eruption, lymphadenopathy, hepatosplenomegaly and pleural effusions, although his prolymphocyte count increased to 910,000/microliters. He died of cerebral bleeding in July, 1991. We diagnosed this case as T-cell prolymphocytic leukemia, observed for five years.
一名54岁男性，已知其幼淋巴细胞计数偏高已达四年，于1990年9月因呼吸困难入住我院。体格检查发现有皮疹、淋巴结病和肝脾肿大。胸部X线显示双侧胸腔积液。白细胞计数为232,900/微升，99%的淋巴细胞有单个核仁。这些细胞表达CD2+、CD3-、CD4+、CD7+和CD8-表型。对这些细胞的DNA进行Southern印迹分析，发现T细胞受体β链基因呈单克隆重排。未检测到抗人类嗜T细胞病毒1型（HTLV-1）抗体和HTLV-1前病毒DNA。皮肤病变的活检标本显示白血病细胞浸润，抗MT1抗体呈阳性。腋窝淋巴结的组织学检查结果为恶性淋巴瘤，弥漫性，中等大小，T细胞型。联合化疗使皮疹、淋巴结病、肝脾肿大和胸腔积液有所改善，尽管其幼淋巴细胞计数增至910,000/微升。他于1991年7月死于脑出血。我们将该病例诊断为T细胞幼淋巴细胞白血病，并观察了五年。
