伴单核细胞样浆细胞的浆细胞白血病临床与实验室特点分析  

Charactertics of plasma cell leukemia with monocytoid morphology

作　　者：陈芳 刘泽法 CHEN Fang;LIU Ze-fa(Department of Clinical Laboratory,Xinghua People's Hospital of Jiangsu Province,Jiangsu Xinghua 225700)

机构地区：[1]江苏省兴化市人民医院检验科,江苏兴化225700 [2]江苏省兴化市人民医院血液科,江苏兴化225700

出　　处：《医学检验与临床》2023年第11期30-34,共5页Medical Laboratory Science and Clinics

摘　　要：目的:对1例伴单核细胞样浆细胞的浆细胞白血病(PCL)的临床表现、形态学特点、免疫表型、染色体核型等进行分析,以提高临床和实验室人员对此病例的认识.方法:回顾性分析江苏省兴化市人民医院2022年6月收治的1例PCL患者的临床资料及实验室检查,并进行文献复习.结果:患者为68岁男性,2年前诊断多发性骨髓瘤(MM)IgG-K型,化疗后获得缓解.2022年6月经外周血及骨髓细胞形态学、流式细胞术免疫分型、免疫固定电泳、染色体核型分析等检查最终诊断为继发性PCL(sPCL).患者病情危重,迅速死亡.结论:PCL恶性程度高,病程危重,浆细胞白血病浆细胞形态多样,但单核细胞样浆细胞比较罕见,极易造成误诊,延误治疗时机,工作中要提高对此形态的认识,及时准确的诊断能使患者生存获益.Objective:To report a case of plasma cell leukemia with monocytoid morphology,and to detail the characteristics of its clinical manifestation,cell morphology,immunophenotype and karyotype analysis,which may show new light on the diagnosis of the disease.Methods:Clinical data and laboratroy examinations of a PCL patient admitted to Xinghua People's Hospital of jiangsu Provice in June 2022 were retrospectively analyzed,and literature review was performed.Results:A 68-year old male was diagnosed with multiple myeloma(MM)IgG-k type 2 years ago,achieved remission with chemotherapy.In June 2022,peripheral blood and bone marrow cell morphology,flow cytometry immunophenotype,chromosome karyotyping and other tests were finally diagnosed as secondary PCL(sPCL).The patient was in a critical condition and died quickly.Conclusion:PCL has a high degree of malignancy,critical course of disease,and pasma cells of PCL are diverse,but monocyte-like plasma cells are relatively rare,which is easy to cause misdiagnosis and delay treatment opportunities.We should improve the understanding of this morphology in work,and timely accurate diagnosis can benefit the survival of patients.

关 键 词：浆细胞白血病 单核细胞样浆细胞 形态学诊断 

分 类 号：R446[医药卫生—诊断学] R733.7[医药卫生—临床医学]