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[粒细胞肉瘤:10例临床与病理分析]

[Granulocytic sarcoma: a clinical and pathologic analysis of ten cases].

作者信息

Hou Zhen-bo, Shi Huai-yin, Liang Xiao, Wang Xin-mei

机构信息

Department of Pathology, Zibo Central Hospital, Zibo 255036, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2012 May;41(5):331-4. doi: 10.3760/cma.j.issn.0529-5807.2012.05.010.

Abstract

OBJECTIVE

To investigate the clinical and pathological features, differential diagnosis of granulocytic sarcoma.

METHODS

The clinical manifestations, histopathological features, immunohistochemistry, treatment and prognosis were analyzed retrospectively in 10 cases of granulocytic sarcoma.

RESULTS

The age of patients ranged from 10 to 56 years (means = 35.8 years). The male-to-female ratio was 1.5:1. Histologically, the malignant cells of granulocytic sarcoma grew in a diffuse pattern. The cytoplasm was scanty, with eosinophilic fine granularity in some cells. The nuclei were round or focally irregular, and had finely dispersed chromatin. The mitotic figures were visible. Immunohistochemical stains for MPO, CD43, CD117, CD34 and CD99 were positive.

CONCLUSIONS

Granulocytic sarcoma can occur in patients of all ages with a male predominance. The diagnosis of granulocytic sarcoma is assisted by the cytochemical stain for naphthol-ASD-chloroacetate esterase and/or immunophenotypic analyses for MPO, CD43, CD117, CD34, CD99. These stains aid in the distinction of granulocytic sarcoma from: lymphoblastic lymphoma, Burkitt lymphoma, diffuse large B-cell lymphoma, small round cell tumours, particularly in children, and blastic plasmacytoid dendritic cell neoplasm.

摘要

目的

探讨粒细胞肉瘤的临床及病理特征、鉴别诊断。

方法

回顾性分析10例粒细胞肉瘤患者的临床表现、组织病理学特征、免疫组化、治疗及预后。

结果

患者年龄10~56岁(平均35.8岁)。男女比例为1.5∶1。组织学上,粒细胞肉瘤的恶性细胞呈弥漫性生长。细胞质稀少,部分细胞有嗜酸性细颗粒。细胞核圆形或局部不规则,染色质分散细小。可见有丝分裂象。髓过氧化物酶(MPO)、CD43、CD117、CD34和CD99免疫组化染色呈阳性。

结论

粒细胞肉瘤可发生于各年龄段患者,男性居多。萘酚-ASD-氯乙酸酯酶细胞化学染色和/或MPO、CD43、CD117、CD34、CD99免疫表型分析有助于粒细胞肉瘤的诊断。这些染色有助于将粒细胞肉瘤与以下疾病相鉴别:淋巴细胞母细胞性淋巴瘤、伯基特淋巴瘤、弥漫性大B细胞淋巴瘤、小圆形细胞肿瘤(尤其是儿童)以及母细胞性浆细胞样树突状细胞肿瘤。

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