急性杂合型白血病的超微结构和电镜诊断  

The ultrastructural analysis of hybrid acute leukemia diagnosis

作　　者：王慧君[1] 茹永新[1] 刘津华[1] 赵轼轩[1] 秘营昌[1] 王建祥[1] 

机构地区：[1]中国医学科学院中国协和医科大学血液学研究所血液病医院,天津 300020

出　　处：《白血病．淋巴瘤》2007年第1期37-39,共3页Journal of Leukemia & Lymphoma

摘　　要：目的回顾性分析急性杂合型白血病（HAL）细胞的超微结构特点。方法选择根据欧洲白血病协作组标准确定诊断的15例HAL，电镜观察HAL细胞组成和超微结构及电镜组化（MPO）结果。结果15例HAL中，电镜诊断与免疫表型诊断相符5例（3例双表型，2例双克隆型）；疑似HAL诊断2例；考虑ALL诊断5例，M5a2例；M4b1例。结论大部分双表型HAL细胞超微结构表现淋系特点，少数表现单核细胞特点或非特异性。电镜对双克隆型及MPO阳性的双表型HAL诊断容易，难以对MPO阴性的双表型HAL与ALL进行结构举别：少数病例容易误诊为M5a。Objective To investigate the components and ultrastructural characteristics of hybrid acute leukemia retrospectively. Methods Observing 15 cases of HAL in term of EGIL by transmission electron microscope （TEM） focusing on organelles and MPO reaction of leukemia ceils. Results According to TEM, 5 out 15 cases of HAL diagnosed with TEM were coincident on immunophenotyping （3 cases of biphenotypic type, 2 cases of biclonal type of HAL with granulocytes and lymphocytes）; 2 cases suspected HAL. Otherwise, 5 cases of HAL assigned to ALL, 2 cases misinterpreted into M5a, and 1 4b respectively. Conclusion The most blast cells of biphenotypic type of HAL showed lymphoid blast features and a few cases exhibited monocytic or non-specific feature. TEM is advantageous in diagnosis of biphenotypic type of HAL and the MPO positive cases of HAL. Inversely, it is difficult to differential MPO negative cases of HAL from ALL, and a few cases maybe mislead as M5 by TEM.

关 键 词：白血病 混合细胞 细胞结构 显微镜检查 电子 透射 

分 类 号：R733[医药卫生—肿瘤]