Ashfaq R, Weinberg A G, Argyle C A
Children's Medical Center, University of Texas Southwestern Medical Center, Dallas.
Am J Clin Pathol. 1992 Jul;98(1):55-60. doi: 10.1093/ajcp/98.1.55.
Acute megakaryoblastic leukemia has emerged as an important subset of early childhood leukemia. It often presents a diagnostic dilemma because of its many morphologic manifestations and propensity to mimic metastatic carcinoma. An abdominal mass was identified by sonographic and computed tomographic scans in a 10-month-old girl, who had anemia and thrombocytopenia. An open biopsy of the 3-cm, peripancreatic mass showed cohesive nests and sheets of tumor cells with focal spindling and desmoplasia. Although the diagnosis of acute megakaryoblastic leukemia was established from a bone marrow aspirate using immunocytochemical techniques and karyotype analysis, a coexistent abdominal epithelial malignant neoplasm could not be excluded entirely by light microscopic examination alone. The megakaryoblastic nature of the abdominal tumor was established by immunocytochemical stains for glycoprotein IIIa on paraffin-embedded tissue.
急性巨核细胞白血病已成为幼儿白血病的一个重要亚型。由于其多种形态学表现以及易被误诊为转移性癌的倾向，它常常带来诊断难题。一名10个月大的贫血和血小板减少的女童经超声和计算机断层扫描发现腹部有肿块。对这个3厘米大小的胰腺周围肿块进行的开放性活检显示，肿瘤细胞呈紧密的巢状和片状，有局灶性梭形变和促纤维组织增生。尽管通过免疫细胞化学技术和核型分析从骨髓穿刺中确诊为急性巨核细胞白血病，但仅通过光学显微镜检查并不能完全排除同时存在腹部上皮性恶性肿瘤。通过对石蜡包埋组织进行糖蛋白IIIa免疫细胞化学染色，确定了腹部肿瘤的巨核细胞性质。
