大颗粒淋巴细胞白血病的形态学和免疫表型特点  

Morphologic and immunophenotypic features of large granular lymphocytic leukemia

作　　者：付杰[1] 解丽丽[1] 李博[1] 邓淑芝[1] 张睿[1] 

机构地区：[1]鸡西市人民医院检验科,黑龙江鸡西158100

出　　处：《临床血液学杂志》2014年第6期987-989,共3页Journal of Clinical Hematology

摘　　要：目的:探讨大颗粒淋巴细胞白血病(LGLL)的形态学和免疫表型特点。方法:回顾性分析22例LGLL患者的外周血涂片、骨髓涂片和免疫表型情况。结果:22例LGLL中T大颗粒淋巴细胞白血病(T-LGLL)14例,侵袭性NK细胞白血病(ANKL)8例。14例T-LGLL和5例ANKL的外周血涂片中可见大颗粒淋巴细胞。12例T-LGLL和7例ANKL的骨髓涂片中淋巴细胞比例增高(>20.0%),11例T-LGLL和5例ANKL的骨髓涂片中可见大颗粒淋巴细胞。流式细胞学示T-LGLL中9例CD3+CD4-CD8+CD56-CD57+,5例免疫标记不典型,其中CD8-3例,CD57-2例。ANKL的免疫表型均为CD2+CD3-CD56+CD57-。6例CD7、4例CD8、1例CD5阳性。结论:LGLL中的T-LGLL和ANKL具有各自独特的形态学和免疫表型特点,二者在LGLL的诊断与鉴别诊断中具有重要的价值。Objective：To explore the morphologic and immunophenotypic features of large granularlymphocytic leukemia （LGLL）. Method.. A retrospective analysis of the peripheral blood and bone marrow smear morphology and immunophenotyping status were performed in 22 patients with LGLL. Result：Of 22 patients, 14 were T-LGLL and 8 were aggressive NK-cell leukemia （ANKL）. Large granular lymphocytes （LGLs） were observed in 14 cases of T-LGLL and 5 cases of ANKL in their peripheral blood smears. In bone marrow smears,lymphocytosis （〉0.2） was seen in 12 cases of T-LGLL and 7 cases of ANKL,white LGLs were observed in 11 cases of T-LGLL and 5 ca- ses of ANKL. Flow cytometry showed an immunophenotype of CD3＋ CD4 CD8＋ CD56 CD57＋ of the tumor ceils in 9 T-LGLLs. Of the other 5 T-LGLLs, the immunophenotypes included CD8 （3 cases） and CD57- （2 cases）. The immunophenotype of ANKLs was CD2＋ CD3-CD56＋ CD57- in all cases and CD7＋ in 6 eases,CD8＋ in 4 cases and CD5＋ in 1 case. Conclusion： The features of T-LGLL and ANKL are distinct and morphologic and immunophe- notypic analysis of both peripheral blood and bone marrow specimens are essential in the diagnosis and differential diagnosis of LGLL.

关 键 词：白血病 大颗粒淋巴细胞 骨髓检查 免疫表型 

分 类 号：R733.7[医药卫生—肿瘤]