Choate J J, Domenico D R, McGraw T P, Fareed J, Molnar Z, Schumacher H R
Department of Medicine, Edward Hines, Jr. Veterans Administration Hospital, Loyola University Medical Center, Maywood, Illinois 60153.
Am J Clin Pathol. 1988 Feb;89(2):247-53. doi: 10.1093/ajcp/89.2.247.
This report demonstrates a case of acute megakaryoblastic leukemia evolving in a patient with idiopathic myelofibrosis with myeloid metaplasia. A presumptive diagnosis was made by cytochemical stains, alpha-naphthyl acetate esterase, and alpha-naphthyl butyrate esterase. The diagnosis was established by electron microscopic platelet peroxidase studies of the peripheral blood blast cells and supported by flow cytometry and immunoalkaline phosphatase studies. Specific monoclonal antibodies directed against platelet glycoproteins Ib (6D1) and IIb/IIIa (10E5), which have not been described frequently in analyzing leukemia, were used for flow cytometry and direct immunoalkaline phosphatase technique. Cytogenetic studies demonstrated a deletion of the long arm of chromosome 6 with breakpoints at bands q15 and q23, and ring chromosome 6 (p25, q27). The diagnosis of megakaryoblastic leukemia requires accurate cytochemical stains, platelet peroxidase by electron microscopic examination, and studies employing specific monoclonal antibodies directed against platelets and megakaryoblasts. The exact origin of the circulating megakaryoblasts in these cases is not known and needs additional investigation.
本报告展示了一例急性巨核细胞白血病病例，该病例发生于一名患有原发性骨髓纤维化伴髓外化生的患者。通过细胞化学染色、α-萘乙酸酯酶和α-萘丁酸酯酶进行初步诊断。通过对外周血原始细胞进行电子显微镜血小板过氧化物酶研究确诊，并得到流式细胞术和免疫碱性磷酸酶研究的支持。针对血小板糖蛋白Ib（6D1）和IIb/IIIa（10E5）的特异性单克隆抗体，在白血病分析中较少被描述，被用于流式细胞术和直接免疫碱性磷酸酶技术。细胞遗传学研究显示6号染色体长臂缺失，断点位于q15和q23带，以及环状染色体6（p25，q27）。巨核细胞白血病的诊断需要准确的细胞化学染色、电子显微镜检查血小板过氧化物酶，以及使用针对血小板和巨核母细胞的特异性单克隆抗体进行研究。这些病例中循环巨核母细胞的确切来源尚不清楚，需要进一步研究。
