Thiele J, Vykoupil K F, Georgii A
Blut. 1979 Sep;39(3):177-90. doi: 10.1007/BF01008447.
Clinical data and light and electron microscopic findings are presented in a patient with chromic myelomonocytic leukemia of about 5 years' duration and no need for specific therapy. Cytogenetic studies failed to demonstrate a Philadelphia-chromosome. The leading clinical symptoms were anemia, moderate hepatomegaly, and leukocytosis with monocytes in the peripheral blood count. Light microscopy of bone marrow cores showed hypercellularity of neutrophil granulocytic and monocytic cell lines including some precursor forms. Electron microscopy confirmed the existence of a biphasic myelomonocytic cell proliferation with predominance of mature forms in both lineages; there were no gross cellular abnormalities and no "hiatus leukaemicus". Consupicuous were cells of an undeterminated origin apparently neither belonging to the neutrophil granulocytic nor monocytic series and large histiocytic cells, possibly corresponding to the so-called sea-blue histiocytes of light microscopy. The high degree of maturation of both cell lines in the bone marrow is in accordance with the relatively benign and prolongated course of this rare type of leukemia.
本文介绍了一名患有慢性粒单核细胞白血病约5年且无需特殊治疗患者的临床数据以及光镜和电镜检查结果。细胞遗传学研究未发现费城染色体。主要临床症状为贫血、中度肝肿大以及外周血白细胞增多伴单核细胞增多。骨髓活检光镜检查显示中性粒细胞系和单核细胞系细胞增多，包括一些前体细胞形态。电镜检查证实存在双相性粒单核细胞增殖，两个谱系中均以成熟形态为主；无明显细胞异常，也无“白血病裂孔”。引人注目的是来源不明的细胞，显然既不属于中性粒细胞系也不属于单核细胞系，还有大的组织细胞，可能对应于光镜下所谓的海蓝色组织细胞。骨髓中两个细胞系的高度成熟与这种罕见类型白血病相对良性和病程延长相符。
