Wick M R, Li C Y, Ludwig J, Levitt R, Pierre R V
Mayo Clin Proc. 1980 Feb;55(2):108-12.
Chronic lymphocytic leukemia rarely develops an acute blastic phase as a terminal complication. When it does, the blastic phase is characterized by the appearance of large, immature cells with the same immunologic markers as the cells in the chronic phase of chronic lymphocytic leukemia; this coexistence of mature lymphocytes and blastic forms in chronic lymphocytic leukemia has been termed "Richter's syndrome." In a patient of ours with chronic lymphocytic leukemia, the development of a presumed large cell lymphoma was recognized on both bone marrow aspiration and biopsy examination, but later the condition was proved to be a true histiocytic neoplasm (malignant histiocytosis) by cytochemical and immunohistochemical techniques. We are unaware of another reported instance of malignant histiocytosis as a terminal complication of chronic lymphocytic leukemia and mimicking Richter's syndrome.
慢性淋巴细胞白血病很少发展为急性原始细胞期作为终末期并发症。当出现这种情况时，原始细胞期的特征是出现大量不成熟细胞，其免疫标志物与慢性淋巴细胞白血病慢性期的细胞相同；慢性淋巴细胞白血病中成熟淋巴细胞和原始细胞形式的这种共存被称为“里氏综合征”。在我们的一名慢性淋巴细胞白血病患者中，骨髓穿刺和活检检查均发现了疑似大细胞淋巴瘤，但后来通过细胞化学和免疫组织化学技术证实该病症是一种真正的组织细胞性肿瘤（恶性组织细胞增多症）。我们不知道有另一例恶性组织细胞增多症作为慢性淋巴细胞白血病终末期并发症并类似里氏综合征的报道。
