Sohn S K, Suh J S, Lee J, Lee K B
Department of Clinical Pathology, Kyungpook National University Hospital, Taegu, Korea.
Korean J Intern Med. 1998 Feb;13(1):64-7. doi: 10.3904/kjim.1998.13.1.64.
We report two cases of adult acute lymphoblastic leukemia presenting with preleukemic phase of pancytopenia with a few abnormal lymphoid cells in bone marrow aspirates. The initial diagnosis of each case was suspicious aplastic anemia and hypoplastic anemia. Both cases progressed to overt acute lymphoblastic leukemia within 1 year. We suggest that initial pancytopenic phase (pre-ALL) may precede the diagnosis of acute lymphoblastic leukemia in adults and differential diagnosis from myelodysplastic syndrome and primary aplastic anemia will be needed. We also suggest that primary bone marrow lymphoma and "primary unknown metastatic lymphoma of bone marrow" may be possible as the pathogenesis in a case like ours.
我们报告了两例成人急性淋巴细胞白血病，其表现为全血细胞减少的白血病前期，骨髓穿刺涂片中可见少量异常淋巴细胞。每例患者的初始诊断均为可疑再生障碍性贫血和增生低下性贫血。两例患者均在1年内进展为明显的急性淋巴细胞白血病。我们认为成人急性淋巴细胞白血病的诊断前可能存在初始全血细胞减少期（ALL前期），需要与骨髓增生异常综合征和原发性再生障碍性贫血进行鉴别诊断。我们还认为，在我们这样的病例中，原发性骨髓淋巴瘤和“原发性骨髓未知转移性淋巴瘤”可能是其发病机制。
