Bain B, Manoharan A, Lampert I, McKenzie C, Catovsky D
J Clin Pathol. 1983 May;36(5):559-65. doi: 10.1136/jcp.36.5.559.
Four patients in whom a diagnosis of acute monocytic leukaemia (M5) was subsequently made presented with extramedullary disease clinically resembling lymphoma. In all patients histological sections were initially misinterpreted as showing malignant lymphoma or anaplastic carcinoma. The diagnosis of M5 leukaemia was subsequently made on the basis of morphological and cytochemical studies of peripheral blood and bone marrow. The histological diagnosis of the soft tissue lesions of M5 leukaemia (monocytic sarcoma) is difficult, although features such as abundant cytoplasm and the presence of some reniform nuclei are helpful. If there is no peripheral blood or bone marrow involvement and only fixed paraffin-embedded tissues are available, demonstration of lysozyme by an immunoperoxidase technique may confirm the diagnosis but results are not invariably positive. An early diagnosis of M5 leukaemia has therapeutic implications since the disease evolves through a progressive leukaemia phase and systemic therapy is essential.
4例患者临床出现类似淋巴瘤的髓外疾病，随后被诊断为急性单核细胞白血病（M5）。所有患者的组织学切片最初均被误诊为恶性淋巴瘤或间变性癌。随后根据外周血和骨髓的形态学及细胞化学研究确诊为M5白血病。M5白血病软组织病变（单核细胞肉瘤）的组织学诊断困难，尽管丰富的细胞质和一些肾形核等特征有助于诊断。如果没有外周血或骨髓受累，仅有固定的石蜡包埋组织，免疫过氧化物酶技术检测溶菌酶可能有助于确诊，但结果并非总是阳性。M5白血病的早期诊断具有治疗意义，因为该疾病会经历一个进行性白血病阶段，全身治疗至关重要。
