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毛细胞白血病的骨髓诊断(作者译)

[Bone marrow diagnostic in hairy cell leukaemia (author's transl)].

作者信息

Hahner U, Burkhardt R

出版信息

Klin Wochenschr. 1977 Oct 1;55(19):933-44. doi: 10.1007/BF01479225.

Abstract

Evaluation of the histologic changes of the bone marrow and clinical data of twelve male and two female patients with hairy cell leukamia before treatment. Mean age of the patients was 46 years, time from the onset of symptoms 5.5 months. 13 of the patients were anaemic, showing splenomegaly, 12 suffered from thrombopenia, 9 from granulocytopenia, and 8 from hepatomegaly. In all of the cases, the relative numbers of lymphocytes in the blood had been increased together with various amounts of characteristic hairy cells. All of the cases had a typical histologic picture of lymphocytic bone marrow infiltration, mostly of the diffuse type. In 50% of the cases not only the well known rod-like intracellular inclusions could be seen, but also ring-shaped figures whose significance is discussed. Decrease of the granulopoiesis, disintergration of the marrow sinusoids, and osteoporosis are the most important additional signs. The progression of the disease is marked by increasing bone marrow infiltration, by splenohepatomegaly, anaemia, thrombopenia, and increasing numbers of typical lymphocytes in the blood. The bone marrow being considered to be the origin of the disease for good reasons, the histobiopsy of this organ ranks among the diagnostic and prognostic measures to be taken at first sight.

摘要

对12例男性和2例女性毛细胞白血病患者治疗前的骨髓组织学变化及临床资料进行评估。患者平均年龄46岁,症状出现时间为5.5个月。13例患者贫血,有脾肿大,12例有血小板减少,9例有粒细胞减少,8例有肝肿大。所有病例血液中淋巴细胞的相对数量均增加,并伴有不同数量的特征性毛细胞。所有病例均有典型的淋巴细胞骨髓浸润组织学表现,大多为弥漫型。50%的病例不仅可见众所周知的棒状细胞内包涵体,还可见环形结构,其意义有待探讨。粒细胞生成减少、骨髓血窦解体和骨质疏松是最重要的其他体征。疾病进展的标志是骨髓浸润增加、脾肝肿大、贫血、血小板减少以及血液中典型淋巴细胞数量增加。鉴于骨髓被认为是该疾病的起源,有充分理由,对该器官进行组织活检是首要采取的诊断和预后措施之一。

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