浆细胞胞浆含明显颗粒κ轻链型多发性骨髓瘤临床回顾分析  

Retrospective clinical analysis ofκlight chain multiple myeloma with cytoplasmic granules

作　　者：王洪玲 李莉[1] 张春玲 蔺丽慧[1] 丁静 李会丹 魏道林 白萍 WANG Hongling;LI Li;ZHANG Chunling;LIN Lihui;DING Jing;LI Huidan;WEI Daolin;BAI Ping(Department of Clinical Laboratory,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China;Department of Hematology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China)

机构地区：[1]上海交通大学医学院附属第一人民医院检验科,上海201600 [2]上海交通大学医学院附属第一人民医院血液科,上海201600

出　　处：《检验医学》2021年第8期818-822,共5页Laboratory Medicine

基　　金：第一轮促进市级医院临床技能与临床创新三年行动计划(16CR3098B)。

摘　　要：目的分析多发性骨髓瘤浆细胞胞浆中的常见包涵体,为多发性骨髓瘤浆细胞形态学诊断提供参考。方法采用瑞-吉染色法,查找1例κ轻链型多发性骨髓瘤患者骨髓细胞涂片中极罕见的浆细胞,并结合国内外相关文献,对类似病例进行回顾分析。结果形态学检查发现可能为嗜天青颗粒的大小不等、较不规则、紫红色的包涵体样颗粒。相关研究结果表明,多发性骨髓瘤的浆细胞胞浆常见包涵体样颗粒包括Russell小体、Mott细胞、Dutcher小体、类Auer小体等,可能有一定的临床意义。结论罕见异常浆细胞的形态学诊断对轻链型多发性骨髓瘤和浆细胞中出现包涵体的多发性骨髓瘤的诊断有重要的参考价值。Objective To analyze cytoplasmic inclusions in plasma cells of multiple myeloma,that will be useful for the morphological diagnosis of multiple myeloma with abnormal plasma cells.Methods A rare kind of plasma cells was found in the bone marrow smear ofκlight chain multiple myeloma using Wright-Giemsa staining.The case was analyzed retrospectively,and the relevant literatures in Pubmed were searched.Results Abnormal plasma cell cytoplasma in this case showed obvious,different-sized,irregular and purple-red granules.The granules in this case may be azurophilic granules.Russell bodies,Mott cells,Dutcher bodies and Auer rod-like inclusions were common intra-cytoplasmic inclusions in plasma cells.These inclusions may play roles in clinic.Conclusions The morphological diagnosis of multiple myeloma with abnormal plasma cells plays a role in the diagnosis of light chain multiple myeloma or multiple myeloma with abnormal plasma cell inclusions.

关 键 词：浆细胞 嗜天青颗粒 形态学诊断 轻链型多发性骨髓瘤 

分 类 号：R446.1[医药卫生—诊断学]