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以下是引用天山望月在2010-5-2 22:50:00的发言: 谢谢侯老师! 骨髓涂片:原始细胞24%,骨髓组织大量成片原始细胞,白血病可以定。 细胞浆蓝色,染色质有点细腻,像淋,而骨髓明显的粒细胞分化谱系,又像粒,总之需组化或流式及基因检测确定。 因看骨髓组织片少,原始粒、原单和原淋在组织片中不知有哪些鉴别点,还望侯老师指点迷津,谢谢! |
From our website, I know that you are a very experienced pathologist. 我们互相学习。 There are some minor different features between myeloid, lymphoid and monocytic blasts. Myeloblasts may have large nuclear with prominent nucleoli and more cytoplasm. Lymphoblasts often have smaller nuclear and scant cytoplasm. Monoblasts often have large irregular shaped nuclear. All these features are relative. We have flow cytometry and marrow aspirate smear on all most all the bone marrow biopsies. Therefore, we already know the morphology and phenotype of the acute leukemia before we get the biopsy section. The tissue section itself gives very little more information about the leukemia unless you want to do immunohistochemical study. If it is a transformed acute leukemia, the biopsy section is very useful to determine if patient had prior MDS or MPD. |
以下是引用侯军在2010-5-5 5:43:00的发言: These are the selected flow cytometry study results. In addition, the blasts are also positive for CD15, HLA-DR, CD16/56, MPO and negative for T- and B- cell markers. This is an acute myeloid leukemia. What type? What else we should do with this patient? |
这里选择了一些流式细胞仪检查的结果。另外,原始细胞CD15, HLA-DR, CD16/56和MPO阳性,而T和B细胞标记阴性。这是急性髓系白血病。什么类型?对于该病人我们还能做些什么事情?
以下是引用侯军在2010-5-2 9:53:00的发言:
Clinical History.
54 y/o male patient found to be anemic. Upon review of peripheral blood smear, blasts present. Bone marrow biopsy performed.
Lab. Hgb 8.0g/dL, WBC 7.8k/ul with blasts 24%, Platelet 76,000/ul
This is the first time for me to post a case. I will post the flow cytometry study later.
五 一 节 快 乐 !!!! |
临床病史:54岁男性,贫血。外周血涂片显示原始粒细胞。进行骨髓活检。实验室检查:血色素8.0g/dl, WBC7.8k/ul, 其中原始粒细胞占24%, 血小板76000/ul。
这是我第一次发帖,随后我会发出流式细胞仪的结果。