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- 好的、少见的骨髓涂片病例
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I agree with 天山望月 's Diagnosis. It looks like hairy cell leukemia morphologically. Is the TRAP satin positive? If you do flow cytometry study, these cells should be bright CD11c positive, CD103 positive and Bright CD22 positive.
One other differential diagnosis could be CD5 negative atypical CLL. If the patient has multiple enlarged lymph nodes plus hepatomegaly and splenomegaly , marrow involvement by marginal zone lymphoma is also possible. Flow cytometry study is very helpful in this situation.
Tell us more, 海燕
| 以下是引用侯军在2010-5-3 11:29:00的发言： I agree with 天山望月 's Diagnosis. It looks like hairy cell leukemia morphologically. Is the TRAP satin positive? If you do flow cytometry study, these cells should be bright CD11c positive, CD103 positive and Bright CD22 positive. |
我同意天山望月的诊断，它在形态学上看起来像毛细胞白血病。TRAP染色是否阳性？假如你们做过流式细胞仪的检查，这些细胞应当是明亮的CD11c阳性，CD103阳性和明亮的CD22阳性。鉴别诊断之一应该是CD5阴性的不典型慢性淋巴细胞白血病。假如病人有多个肿大的淋巴结，再加上肝脏肿大，脾脏肿大，边缘区淋巴瘤累及骨髓也是可能的。在这种情况下，流式细胞仪非常有帮助。请补充病史，海燕。
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It is relatively easy to differentiate hairy cell leukemia from marginal zone lymphoma phenotypically by flow cytometry. Marginal zone lymphoma are CD19+, CD20+, Clonal (kappa or lambda), CD5-, CD10- and CD23-. Hairy cell leukemia has all above features plus bright CD11c +, CD103+ and Bright CD22+. The definition of "Bright" in flow cytometry is the intensity of the staining above 10x3. Because the hairy cells have abundant cytoplasm and larger surface area, the most of antibodies used in the study are brighter than that of the marginal zone lymphoma.
| 以下是引用侯军在2010-5-8 11:12:00的发言： It is relatively easy to differentiate hairy cell leukemia from marginal zone lymphoma phenotypically by flow cytometry. Marginal zone lymphoma are CD19+, CD20+, Clonal (kappa or lambda), CD5-, CD10- and CD23-. Hairy cell leukemia has all above features plus bright CD11c +, CD103+ and Bright CD22+. The definition of "Bright" in flow cytometry is the intensity of the staining above 10x3. Because the hairy cells have abundant cytoplasm and larger surface area, the most of antibodies used in the study are brighter than that of the marginal zone lymphoma. |
通过流式细胞仪能够相对容易地将毛细胞性白血病和边缘区淋巴瘤进行鉴别。边缘区淋巴瘤CD19+, CD20+, kappa 或者lambda克隆性阳性， CD5-, CD10-和CD23-。 毛细胞性白血病具有以上所有特征并加上明亮的CD11c+, CD103+和明亮的CD22+. 在流式细胞仪中明亮的定义是其染色强度超过了10x3． 因为毛细胞含有丰富的胞浆和更大的体表面积，在检查中所使用的大部分抗体都是比边缘区淋巴瘤的抗体要更加地明亮。
