Yamazaki Etsuko, Kanai Makiko, Sakai Rika, Sakamoto Hiroshi, Ishigatsubo Yoshiaki
Division of Hematology and Immunology, Fujisawa City Hospital.
Rinsho Ketsueki. 2005 Mar;46(3):217-9.
We report a chronic myelomonocytic leukemia (CMML) patient whose initial symptom was pleural effusion, which is extremely rare. A 61-year-old male was referred to our hospital because of leukocytosis with blasts and pleural effusion with chest pain. Bone marrow examination showed trilineage dysplasia with 14% blasts and a normal karyotype. He was diagnosed as having MDS (RAEB) and infectious pleuritis on admission. Despite administration of antibiotics, leukocytosis with monocytosis and pleural effusion progressed rapidly. His diagnosis was then changed to CMML-2 and pleural infiltration due to leukemic cells expressing CD13, CD14 and CD33. After the leukocytosis was brought under control with hydroxycarbamide, the patient's pleural effusion disappeared.
我们报告了一例慢性粒单核细胞白血病（CMML）患者，其初始症状为胸腔积液，极为罕见。一名61岁男性因伴有原始细胞的白细胞增多症以及伴有胸痛的胸腔积液被转诊至我院。骨髓检查显示三系发育异常，原始细胞占14%，核型正常。入院时他被诊断为骨髓增生异常综合征（RAEB）和感染性胸膜炎。尽管使用了抗生素，但单核细胞增多性白细胞增多症和胸腔积液仍迅速进展。随后其诊断改为CMML-2，且由于白血病细胞表达CD13、CD14和CD33导致胸腔浸润。在使用羟基脲控制白细胞增多症后，患者的胸腔积液消失。
