髓系肉瘤误诊为非霍奇金淋巴瘤1例病例分析合并文献复习  

Literature Review and Case Analysis of 1 Case of Medullary Sarcoma Misdiagnosed as Non-hodgkin Lymphoma

作　　者：戴铁颖[1] 沈建平[1] 胡致平[1] 林圣云[1] 武利强[1] 周郁鸿[1] 倪桂宝[1] 

机构地区：[1]浙江中医药大学附属第一医院,杭州310006

出　　处：《浙江中医药大学学报》2012年第11期1204-1207,共4页Journal of Zhejiang Chinese Medical University

摘　　要：[目的]从临床误诊病例的分析认识髓系肉瘤(myeloid sarcoma,MS)这一特殊类型急性髓细胞白血病的诊治要点及预后。[方法]MS特指在髓外由髓系原始细胞或不成熟髓细胞组成的肿块。通过分析该误诊病例临床的起病特点、诊断经验、疗效及预后并就其临床表现、诊断要点、治疗及预后、目前存在的困惑做一探讨,以期对该类疾病获得更深刻的认识。[结果]分析发现MS起病及表现均多样,诊断不易,病理及免疫组化等多方式结合判断不易误诊,本病预后不良。[结论]MS是急性髓系白血病的一特殊类型,因其起病及表现多样,临床易误诊,组织病理诊断为金标准,综合采用新的实验手段,如细胞分子学表型、基因学检测等有助于诊断及判断预后,建议早期大剂量Arac联合骨髓移植治疗改善预后。[Objective]To recognize and analyse the diagnosis and prognosis of the special acute myelocyte cell leukemia,myeloid sarcoma（MS）.[Method] MS is the lump formed with medullary primary cell or unmature medullary cell out of the marrow.With analyzing the occurrence,diagnosis,cure effect and prognosis,it makes discussion on its clinical symptoms,treatment and present puzzle,hoping for a further recognition of the disease.[Result] It finds out that MS occurrence and symptoms are various,it is hard to diagnose,we shall combine pathological and immunohistochemistric methods for correct diagnosis;it has bad prognosis.[Conclusion] MS is a special type of acute medullary leukemia,whose diagnosis shall take histo-pathological standard,comprehensively with new tests,such as cell molecules phenotype and genetics test,etc.It also suggests for early large Arac combined with BMT therapy to improve the prognosis.

关 键 词：MS 非霍奇金淋巴瘤 免疫表型 化疗 误诊 

分 类 号：R273[医药卫生—中西医结合]