Polli N, Lambertenghi-Deliliers G, Schirò R, Cattoretti G, Soligo D, Cantù-Rajnoldi A, Romitti L, Delia D, Polli E E
Haematologica. 1989 Mar-Apr;74(2):129-36.
Nine cases of acute leukemia presenting unusual phenotype were studied by light microscopy (LM) cytochemistry and transmission electron microscopy (TEM) immunocytochemistry with the immunogold staining (IGS) method; in addition, cytogenetic and molecular analyses were performed. The presence of myeloperoxidase (MPO) was studied at TEM in combination with immunophenotype to identify minor populations not characterizable at LM. Four of nine cases had no TEM/MPO reactivity, whereas the remaining five showed variable percentages of positive cells. Of the MPO negative cases, one was a megakaryoblastic leukemia with a positive platelet peroxidase (PPO) reaction, and three were lymphoid. Among the peroxidase positive cases, the percentage of MPO reactive cells was higher at TEM than at LM examination. In case 5 TEM analysis indicated that cells with some MPO reactivity at LM were non neoplastic myeloid cells. With this combined technique in cases 1 and 2 we excluded the presence of the MPO enzyme in CD15 positive lymphoid cells and, in another case, we documented the existence of CD19/MPO positive cells. The value of cytochemistry and immunology at the ultrastructural level for the characterization of blast cells and for the precise diagnosis of leukemia with "unusual" phenotype is illustrated.
采用光学显微镜（LM）细胞化学、透射电子显微镜（TEM）免疫细胞化学及免疫金染色（IGS）方法对9例呈现异常表型的急性白血病病例进行了研究；此外，还进行了细胞遗传学和分子分析。在TEM下结合免疫表型研究髓过氧化物酶（MPO）的存在情况，以识别LM无法表征的少数细胞群体。9例病例中有4例无TEM/MPO反应性，而其余5例显示出不同比例的阳性细胞。在MPO阴性病例中，1例为巨核细胞白血病，血小板过氧化物酶（PPO）反应阳性，3例为淋巴细胞白血病。在过氧化物酶阳性病例中，TEM检测到的MPO反应性细胞百分比高于LM检查。在病例5中，TEM分析表明，LM下有一些MPO反应性的细胞为非肿瘤性髓细胞。通过这种联合技术，在病例1和病例2中，我们排除了CD15阳性淋巴细胞中MPO酶的存在，在另一例病例中，我们记录了CD19/MPO阳性细胞的存在。阐述了超微结构水平的细胞化学和免疫学在原始细胞表征及“异常”表型白血病精确诊断中的价值。
