一例前体B细胞急性淋巴细胞白血病无白血病表现患者的纵隔肿块和恶性胸腔积液
Mediastinal mass and malignant pleural effusion in an aleukemic case with pre-B acute lymphoblastic leukemia.
作者信息
Pei Sung-nan, Kuo Ching-yuan, Ma Ming-chun, Wang Ming-chung
机构信息
Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
出版信息
J Pediatr Hematol Oncol. 2009 Feb;31(2):139-41. doi: 10.1097/MPH.0b013e31818c2619.
Pleural effusions and mediastinal masses are associated with certain types of hematologic malignancies. We report a 20-year-old man with a pleural effusion, a mediastinal mass, and a normal hemogram. The cytology of the pleural effusion initially suggested a lymphoma. However, an immunophenotypic study of the effusion revealed the following: TdT+, CD34+, CD19+, CD7(-), CD33(-), CD10(-), sIgM(-), and positive cytoplasmic mu heavy-chain immunoglobulins. After a bone marrow examination, we diagnosed the patient with pre-B acute lymphoblastic leukemia (ALL). This is the first reported case of a malignant pleural effusion and a mediastinal mass that preceded pre-B ALL. After standard therapy for ALL, the patient has been disease-free for 7 years.
胸腔积液和纵隔肿块与某些类型的血液系统恶性肿瘤有关。我们报告了一名20岁男性，有胸腔积液、纵隔肿块，但血常规正常。胸腔积液的细胞学检查最初提示为淋巴瘤。然而，对积液的免疫表型研究显示如下：末端脱氧核苷酸转移酶（TdT）阳性、CD34阳性、CD19阳性、CD7阴性、CD33阴性、CD10阴性、表面免疫球蛋白M（sIgM）阴性，以及胞质μ重链免疫球蛋白阳性。经骨髓检查后，我们诊断该患者为前B细胞急性淋巴细胞白血病（ALL）。这是首例报道的前B细胞ALL之前出现恶性胸腔积液和纵隔肿块的病例。经过ALL的标准治疗后，该患者已无病生存7年。
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