Anand M, Kumar R, Kumar L, Barge S, Singh S
Unit of Laboratory Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Indian J Cancer. 2003 Oct-Dec;40(4):144-7.
A 61-year old woman presented to us with fever, weakness and ecchymotic patches for one year. She had leucocytosis, anemia and thrombocytopenia. Peripheral blood smear showed 62% neutrophils, 32% myelocytes and metamyelocytes, 2% promyelocytes, 1% blasts, 2% monocytes, 1% lymphocytes but no basophils and marked dyspoiesis. Bone marrow picture was essentially the same. A diagnosis of atypical chronic myeloid leukemia was suggested. The correct diagnosis of chronic myeloid leukemia-accelerated phase was, however, made on cytogenetic analysis which showed Philadelphia chromosome (Ph) and isochromosome 17q [i(17q)]. This case describes a rare and diagnostically difficult presentation of CML arising out of a combination of prominent dyspoiesis and near absence of peripheral blood basophils.
一名61岁女性因发热、乏力和瘀斑1年前来就诊。她有白细胞增多、贫血和血小板减少。外周血涂片显示中性粒细胞62%，中幼粒细胞和晚幼粒细胞32%，早幼粒细胞2%，原始细胞1%，单核细胞2%，淋巴细胞1%，但无嗜碱性粒细胞，且有明显的发育异常。骨髓象基本相同。曾怀疑是非典型慢性髓系白血病。然而，细胞遗传学分析显示费城染色体（Ph）和17号染色体等臂染色体[i(17q)]，从而做出了慢性髓系白血病加速期的正确诊断。该病例描述了一种罕见且诊断困难的慢性髓系白血病表现，其由显著的发育异常和外周血嗜碱性粒细胞几乎缺失共同导致。
