Paolino W, Infelise V, Degani G, Falda M, Paolino F, Fiorio C, Marmont F, Coda R
Minerva Med. 1980 Aug 25;71(30):2115-23.
161 cases of CML have been studied. Clinically significant adenopathies were present in 3,2% of the patients at the moment of diagnosis, and in the subsequent course they appeared in 7% of them. The behaviour of adenopathies showed to be unrelated to: --splenomegaly; --blastic metamorphosis in the peripheral blood or in the marrow (which they often preceded from 3 to 26 months); --hematological sensibility to cytostatic therapy; and furthermore they often acted as the most important clinical and therapeutic problem. From the cyto-histological point of view three features have been observed: 1) blastic metamorphosis in a lymphnode showing features of myeloid metaplasia; 2) blastic invasion in a lymphnode without any sign of myeloid metaplasia; 3) malignant lymphoma. Cytological examination of imprints and ultrastructural studies, besides the usual histological investigations, proved to be useful for the definition of the above mentioned features. In lymphomatous forms, together with the study of the cariotype and the research of the Ph' chromosome, the performance of immunocytological investigations is also necessary.
对161例慢性粒细胞白血病患者进行了研究。诊断时3.2%的患者存在具有临床意义的淋巴结病，在随后的病程中，7%的患者出现了淋巴结病。淋巴结病的表现与以下因素无关：——脾肿大；——外周血或骨髓中的原始细胞变形（淋巴结病通常在其之前3至26个月出现）；——对细胞毒性疗法的血液学敏感性；此外，淋巴结病常常成为最重要的临床和治疗问题。从细胞组织学角度观察到三个特征：1）淋巴结出现具有髓样化生特征的原始细胞变形；2）淋巴结出现原始细胞浸润且无任何髓样化生迹象；3）恶性淋巴瘤。除常规组织学检查外，对印片进行细胞学检查和超微结构研究，被证明有助于明确上述特征。在淋巴瘤形式中，除了研究核型和寻找Ph'染色体外，进行免疫细胞学检查也是必要的。
