淋巴浆细胞淋巴瘤骨髓细胞形态学特征诊断分析  

Diagnostic analysis of bone marrow cytomorphology features in lymphoplasmacytic lymphoma

作　　者：高飞[1] 陈灿伟 张凤[1] 林雅静[1] 张水检 许丽云[1] 

机构地区：[1]福建医科大学附属协和医院福建省血液病研究所福建省血液病学重点实验室,福州350001

出　　处：《福建医药杂志》2016年第4期58-62,F0004,共6页Fujian Medical Journal

基　　金：福建医科大学大学生创新创业训练计划项目(C13004)

摘　　要：目的探索淋巴浆细胞淋巴瘤(LPL)骨髓细胞形态学主要特征,为诊断及鉴别诊断LPL提供细胞形态学依据。方法回顾分析我院2010-2014年初诊LPL患者57例白细胞、血红蛋白、血小板、免疫球蛋白、骨髓活检免疫标记,骨髓增生程度、组织嗜碱细胞比例,淋巴样浆细胞(LPC)比例及分布,浆细胞比例等指标。结果 LPL患者白细胞增高占24.6%(14/57),减少患者占26.3%(15/57),血红蛋白减少患者占78.9%(45/57),血小板减少患者21.1%(12/57);骨髓有核细胞增生活跃及明显活跃占90.2%(46/51),极度活跃9.8%(5/51);组织嗜碱细胞增多比例62.7%(32/51),淋巴样浆细胞可见集簇分布患者占88.2%(45/51),外周血LPC比例平均为28.2%,骨髓为45.5%,骨髓浆细胞比例平均为2.2%。结论骨髓细胞形态学是诊断LPL的重要手段,LPL患者骨髓细胞细胞形态学有独特的特征,系统掌握LPL骨髓细胞形态学特征可以快速、准确诊断LPL。Objective To explore the main features of bone marrow cytomorphology in Lymphoplasmacytic lymphoma（LPL）and provide the basis for diagnosis and differential diagnosis for LPL.Methods Fifty seven cases who were diagnosed LPL patients in our hospital from 2010 to 2014of white blood cell,hemoglobin,platelets,immunoglobulin,bone marrow biopsy immunophenotype,degree of bone marrow hyperplasia,tissue basophil cell ratio,lymphoplasmacytic cell（LPC）ratio and distribution,plasma cell percentage of the index were retrospective analysis.Results White blood cell increased to 24.6%（14/57）,and decreased to 26.3%（15/57）of LPL patients,and 78.9%（45/57）of LPL patients decreased hemoglobin,and21.1%（12/57）patients had thrombocytopenia.Activity and obvious activity of bone marrow nuclear cell hyperplasia accounted for 90.2%（46/51）,and hyperactive for 9.8%（5/51）of LPL patients.Tissue basophilic cells increased to 62.7%（32/51）of patients.Patients with clustered distribution of LPC accounted for 88.2%（45/51）.The average proportion of LPC was 28.2%in peripheral blood,and 45.5%in bone marrow.While the average proportion of plasma cells in bone marrow was 2.2%.Conclusion Bone marrow cell morphology is an important means of diagnosis of LPL,which is an unique characteristic in LPL patients.Systematic understanding of the LPL bone marrow cell morphological characteristic facilitates can diagnose the LPL fast and accuratdely.

关 键 词：淋巴浆细胞淋巴瘤 淋巴样浆细胞 骨髓细胞形态学 

分 类 号：R733.1[医药卫生—肿瘤]