Liu Keyu, Yu Yanfang, Chai Xiaolei, Song Huijuan, Yin Junping, Zhao Lizhen, Fu Zexian
Department of Clinical Laboratory, Affiliated Hospital of Engineering University of Hebei, Hebei Province, China.
Department of Hematology, Affiliated Hospital of Engineering University of Hebei, Hebei Province, China.
Ann Clin Lab Sci. 2018 Nov;48(6):805-807.
A 71-year-old woman presented with acute monocytic leukemia with lymphoma-like morphologic features and an unusual complex karyotype. Bone marrow (BM) aspiration revealed acute monocytic leukemia with lymphoma-like morphologic features. Thus, we called the condition a lymphoma presentation. The patient was diagnosed with acute monocytic leukemia (AML FAB M5a) according to the French-American-British (FAB) classification and the new World Health Organization (WHO) classification [1]. To our knowledge, this is the first reported case of an unusual complex karyotype in acute monocytic leukemia with a lymphoma presentation and adds to the expanding list of karyotypic abnormalities seen in acute monocytic leukemia. We present the case given its rarity, occasional misdiagnosis and poor prognosis. Whether this complex karyotype resulted in such lymphoma-like morphologic features remains to be determined. The case illustrates the importance of the morphologic features cognition and avoiding misdiagnosis. Clinical trials are available to further explore how to extend survival time and contribute to a better prognosis for patients suffering from acute monocytic leukemia with a complex karyotype.
一名71岁女性患者，患有具有淋巴瘤样形态学特征和异常复杂核型的急性单核细胞白血病。骨髓穿刺显示为具有淋巴瘤样形态学特征的急性单核细胞白血病。因此，我们将这种情况称为淋巴瘤表现型。根据法国-美国-英国（FAB）分类法和世界卫生组织（WHO）新分类法，该患者被诊断为急性单核细胞白血病（AML FAB M5a）[1]。据我们所知，这是首例报道的具有淋巴瘤表现型的急性单核细胞白血病伴异常复杂核型的病例，这也增加了急性单核细胞白血病中所见核型异常的种类。鉴于其罕见性、偶尔的误诊及预后不良，我们报告了该病例。这种复杂核型是否导致了这种淋巴瘤样形态学特征仍有待确定。该病例说明了认识形态学特征及避免误诊的重要性。目前有临床试验可进一步探索如何延长生存时间，并为患有复杂核型急性单核细胞白血病的患者带来更好的预后。
