Schwarzmeier J D, Radaszkiewicz T, Graninger W, Hofer F, Paietta E, Moser C
Klin Wochenschr. 1981 Dec 1;59(23):1313-8. doi: 10.1007/BF01711181.
Chronic lymphatic leukemia (CLL was diagnosed in 71 patients based on clinical data. Most of the patients were in the stages 0, I and II, only 18% were in the stages III and IV according to Rai. In all cases, the disease was characterized by an increased number of B lymphocytes (B-CLL). The B cells mostly expressed a weak fluorescence intensity when tested for membrane bound immunoglobulins (Ig). In accordance to that, the quantitative measurement of Ig in the serum revealed a decrease of one or more Ig classes in 72% of the patients. No correlation existed between the number of b lymphocytes (and T lymphocytes) or the Ig concentration in the serum and the stage of the disease. To distinguish the CLL from related lymphoproliferative disorders, especially the immunocytic lymphoma, lymph node biopsies were examined histologically and immunomorphologically for intracytoplasmic Ig. This examination confirmed the diagnosis of CLL in 33 out of 40 cases. Six lymph nodes were classified as immunocytic lymphoma of the lymphoplasmacytoid type. In three of the latter, the immunocytic lymphoma was clinically associated with decreased Ig concentrations in the serum. These findings emphasize that the clinically established diagnosis of CLL should be corroborated by immunomorphology.
根据临床资料,71例患者被诊断为慢性淋巴细胞白血病(CLL)。大多数患者处于0、I和II期,根据Rai分期,只有18%的患者处于III和IV期。在所有病例中,疾病的特征是B淋巴细胞数量增加(B-CLL)。当检测膜结合免疫球蛋白(Ig)时,B细胞大多表现出弱荧光强度。据此,血清中Ig的定量测量显示72%的患者一种或多种Ig类别减少。B淋巴细胞(和T淋巴细胞)数量或血清中Ig浓度与疾病分期之间不存在相关性。为了将CLL与相关的淋巴增殖性疾病,尤其是免疫细胞淋巴瘤区分开来,对淋巴结活检进行了组织学和免疫形态学检查,以检测胞浆内Ig。这项检查在40例病例中的33例中证实了CLL的诊断。6个淋巴结被分类为淋巴浆细胞样型免疫细胞淋巴瘤。在其中3例中,免疫细胞淋巴瘤在临床上与血清中Ig浓度降低有关。这些发现强调,临床确诊的CLL应通过免疫形态学加以证实。