Jayasudha A V, Nair Rekha A, Jacob Priya Mary, Renu S, Anila K R, Sindhu Nair P, Priya Kumari T, Kusuma Kumary P
Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, India.
Department of Pediatrics, Regional Cancer Centre, Thiruvananthapuram, India.
Indian J Hematol Blood Transfus. 2015 Jun;31(2):169-73. doi: 10.1007/s12288-014-0413-1. Epub 2014 Jun 13.
Acute megakaryoblastic leukemia is a rare subtype of acute myeloid leukemia with a characteristic morphologic and immunophenotypic profile. It has to be distinguished from other subtypes of acute myeloid leukemia as well as acute myeloid leukemia with t (1; 22) (p13;q13) and acute megakaryoblastic leukemia in Down Syndrome because of its poor prognosis. We studied ten cases diagnosed over a period of 2 years (from July 2011 to June 2013). All the ten cases were in the pediatric age group ranging from 4 months to 2 years. On morphology, pointers to the diagnosis were clustering of blasts, presence of cytoplasmic blebs and platelet budding. An additional interesting morphological feature observed in our study was nuclear blebs which were seen in nine cases. Diagnosis was confirmed in all cases by positive immunostaining for CD61. Two of the cases had an extremely rare clinical presentation as granulocytic sarcoma. Although rare, acute megakaryoblastic leukemia should be kept in mind especially in leukemia in infants.
急性巨核细胞白血病是急性髓系白血病的一种罕见亚型，具有独特的形态学和免疫表型特征。由于其预后较差，必须将其与急性髓系白血病的其他亚型以及伴有t(1;22)(p13;q13)的急性髓系白血病和唐氏综合征中的急性巨核细胞白血病相鉴别。我们研究了2年期间（从2011年7月至2013年6月）诊断的10例病例。所有10例病例均为儿童年龄组，年龄范围从4个月至2岁。在形态学上，诊断要点为原始细胞聚集、存在胞质小泡和血小板芽。我们研究中观察到的另一个有趣的形态学特征是核小泡，9例病例中可见。所有病例通过CD61免疫染色阳性得以确诊。其中2例病例表现为极其罕见的粒细胞肉瘤临床症状。尽管罕见，但急性巨核细胞白血病尤其在婴儿白血病中应予以考虑。
