Nakajima M, Fukunaga H, Amano M, Fukuda T, Ryo R
Rinsho Ketsueki. 1989 Jul;30(7):1084-8.
A 62-year-old man was admitted to our hospital with exertional dyspnea. On admission, neither hepatosplenomegaly nor lymphadenopathy were noted. Laboratory data revealed anemia (Hb, 4.8 g/dl), leukopenia (2,800 microliters) and a normal platelet count (21 X 10(4)/microliters). The immature blast cells in the peripheral blood were 15%, which increased to 32% during his clinical course. On cytochemical studies, the blast cells had no staining with peroxidase, alpha-naphthyl-butyrate esterase and PAS, although acid phosphatase was positive. More than 58% of the blasts were identified as being of megakaryocytic lineage by platelet peroxidase and by tests with monoclonal GP IIb/IIIa antibody. Bone marrow biopsy disclosed marked fibrosis. However, the patient constantly had normal counts of platelets ranging from 21 X 10(4) to 63 X 10(4)/microliters. This case provides evidence that the megakaryocytic leukemias can be categorized into two types, which are characterized by either undifferentiated or differentiated megakaryocytic leukemia cells.
一名62岁男性因劳力性呼吸困难入院。入院时，未发现肝脾肿大及淋巴结病。实验室检查数据显示贫血（血红蛋白，4.8 g/dl）、白细胞减少（2800/微升），血小板计数正常（21×10⁴/微升）。外周血中幼稚原始细胞占15%，在其病程中升至32%。细胞化学研究显示，原始细胞过氧化物酶、α-萘丁酸酯酶及PAS染色均阴性，而酸性磷酸酶呈阳性。通过血小板过氧化物酶及单克隆GP IIb/IIIa抗体检测，超过58%的原始细胞被鉴定为巨核细胞系。骨髓活检显示显著纤维化。然而，患者血小板计数持续正常，范围在21×10⁴至63×10⁴/微升之间。该病例证明巨核细胞白血病可分为两种类型，其特征分别为未分化或分化的巨核细胞白血病细胞。
