一名老年患者的自然杀伤细胞型侵袭性颗粒淋巴细胞白血病

Aggressive granular lymphocyte leukemia of natural killer cell type in an elderly patient.

作者信息

Ichikawa N, Kitano K, Higuchi M, Kobayashi H, Terada N, Shimodaira S, Sonoyama M, Inoue M, Kawa K, Furuta S

机构信息

Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto.

出版信息

Intern Med. 1993 Nov;32(11):882-5. doi: 10.2169/internalmedicine.32.882.

DOI:10.2169/internalmedicine.32.882

PMID:8012093

Abstract

A 75-year-old man was admitted to our hospital because of intermittent fever. His peripheral blood picture showed granular lymphocyte (GL) proliferation. The GLs were immunologically and functionally phenotyped as natural killer cells. Chromosomal analysis of peripheral lymphocytes with interleukin-2 stimulation revealed an inversion of chromosome 9 with an unusual breakpoint, showing abnormal monoclonal proliferation of the GLs. Progressive increase of GL count and hepatosplenomegaly necessitated the start of combined chemotherapy. His condition was complicated by icterus and renal failure, and he died finally of respiratory failure. Autopsy revealed disseminated intravascular coagulation and infiltration of GLs in the bone marrow, spleen, and liver.

摘要

一名75岁男性因间歇性发热入院。他的外周血象显示颗粒淋巴细胞（GL）增殖。这些GL在免疫和功能上表型为自然杀伤细胞。对白介素-2刺激后的外周淋巴细胞进行染色体分析，发现9号染色体倒位且断点异常，显示GL呈异常单克隆增殖。GL计数逐渐增加以及肝脾肿大使得联合化疗开始。他的病情并发黄疸和肾衰竭，最终死于呼吸衰竭。尸检显示弥散性血管内凝血以及GL浸润骨髓、脾脏和肝脏。