诊断病理学杂志2024,Vol.31Issue(8) :762-764,783.DOI:10.3969/j.jssn.1007-8096.2024.08.012

68例慢性粒细胞白血病骨髓病理诊断分析

Bone marrow pathological diagnosis of chronic myelogenous leukemia:Analysis of 68 cases

张益清
诊断病理学杂志2024,Vol.31Issue(8) :762-764,783.DOI:10.3969/j.jssn.1007-8096.2024.08.012

68例慢性粒细胞白血病骨髓病理诊断分析

Bone marrow pathological diagnosis of chronic myelogenous leukemia:Analysis of 68 cases

张益清1
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作者信息

  • 1. 北京海思特医学检验实验室病理科,北京 100176
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摘要

目的 探讨慢性粒细胞白血病(CML)骨髓病理特征、免疫表型、诊断及鉴别诊断.方法 回顾性分析68例CML患者骨髓活检、网银染色、免疫组织化学、BCR/ABL1融合基因检查结果并复习相关文献.结果 男38例,女30例.68例骨髓活检造血组织容量在60%~90%之间,86.8%(59/68)表现为粒系及巨核两系明显增生,属于CML慢性期(粒系及巨核细胞双增生型).11.8%(8/68)表现为粒系明显增生,巨核细胞增生不明显,属于CML慢性期(粒系单增生型).1.5%(1/68)表现为原始粒细胞明显增生,属于CML急变期.免疫组织化学证实粒系、红系及巨核三系分布情况,RT-PCR检查BCR/ABL1融合基因,100%(68/68)p210融合基因阳性.结论 CML在骨髓活检病理中以慢性期常见,鉴于CML慢性期与PMF较难鉴别,诊断需结合临床表现、病理组织学特点、免疫组化及BCR/ABL1融合基因检测综合诊断.

Abstract

Objective To explore the pathological features,immunophenotypes,diagnosis,and differential diagnosis of CML in bone marrow.Methods Retrospective analysis of bone marrow biopsy,gomon,immunohistochemistry,and BCR/ABL1 fusion gene detection results of 68 patients with CML,and review of relevant literature.Results There are 38 males and 30 females.68 cases of bone marrow biopsy showed a hematopoietic tissue volume between 60-90%,and 86.8%(59/68)showed significant proliferation of both granulocytes and megakaryocytes,belonging to the chronic phase of CML(double proliferation type of granulocytes and megakaryocytes).11.8%(8/68)showed significant proliferation of granulocytes,with no significant proliferation of megakaryocytes,belonging to the chronic phase of CML(granulocytes monoproliferative type).1.5%(1/68)showed significant proliferation of primitive granulocytes,belonging to the acute phase of CML.Immunohistochemistry confirmed the distribution of granulosa,erythroid,and megakaryocyte lineages,RT-PCR examination showed that the BCR/ABL1 fusion gene was 100%(68/68)positive for p210 fusion gene.Conclu-sion CML is commonly seen in the chronic phase of bone marrow biopsy pathology.Considering the difficulty in distin-guishing CML from PMF in the chronic phase,the diagnosis needs to be combined with clinical manifestations,histopatho-logical characteristics,immunohistochemistry,and BCR/ABL1 fusion gene testing for comprehensive diagnosis.

关键词

慢性粒细胞白血病/免疫组化/RT-PCR/BCR/ABL1/骨髓活检

Key words

Chronic myelogenous leukemia/Immunohistochemistry/RT-PCR/BCR/ABL1/Bone marrow biopsy

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出版年

2024
诊断病理学杂志
北京军区总医院

诊断病理学杂志

CSTPCD
影响因子:0.663
ISSN:1007-8096
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