Hwang S M, Chen T P, Liu H W, Lin S F, Chang C S, Liu T C, Yen J H, Tsai W J
Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi. 1990 Jun;6(6):302-8.
We present a patient with philadelphia chromosome (ph')-positive CML with extramedullary blast crisis in the lymph nodes before the bone marrow blast crisis. The morphological and cytochemical studies of lymph node touch preparation, and cytogenetic studies of lymph node tissue confirmed the extramedullary lymphoid blast transformation of CML, while the bone marrow continued to show the chronic phase of CML. When we changed our treatment to use Vincristine-Prednisolone therapy, the lymphadenopathy disappeared gradually. This case shows that the clinical and prognostic features of extramedullary disease can strongly affect disease acceleration in CML, and the therapy should be changed promptly. Besides, cytogenetic study of extramedullary tumor tissue in CML can be useful for accurate diagnosis.
我们报告一例费城染色体（ph'）阳性的慢性髓性白血病（CML）患者，其在骨髓原始细胞危象之前出现了淋巴结髓外原始细胞危象。淋巴结触片的形态学和细胞化学研究以及淋巴结组织的细胞遗传学研究证实了CML的髓外淋巴样原始细胞转化，而骨髓仍显示为CML的慢性期。当我们将治疗改为使用长春新碱 - 泼尼松疗法时，淋巴结病逐渐消失。该病例表明，髓外疾病的临床和预后特征可强烈影响CML的疾病加速，应及时改变治疗方法。此外，对CML髓外肿瘤组织进行细胞遗传学研究有助于准确诊断。
