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髓性白血病髓外浸润33例FNAC诊断
引用本文:陈万新,詹贞芳,范文,樊丽华,刘军.髓性白血病髓外浸润33例FNAC诊断[J].诊断病理学杂志,2004,11(5):334-336,I088.
作者姓名:陈万新  詹贞芳  范文  樊丽华  刘军
作者单位:1. 华中科技大学,同济医学院附属协和医院血液病研究所,武汉,430022
2. 湖北丹江口市汉江医院,检验科,湖北,丹江口,442700
3. 武汉市优抚医院,检验科,武汉,430020
摘    要:目的白血病髓外浸润是针吸细胞病理学(FNAC)诊断的难点,为了提高其诊断准确率。方法对33例髓性白血病髓外浸润的临床及.FNAC诊断结果进行分析总结。结果急性髓细胞性白血病(AML)23例、慢性髓细胞性白血病(CML)10例。AML髓外浸润者平均年龄29.7岁,以成人为多,占69.6%;CML髓外浸润者均大于20岁,平均37.5岁。各部位中以淋巴结浸润最多,占78.8%。结论髓性白血病髓外浸润的FNAC诊断应紧密结合临床及有关实验室检查,否则较易误诊,特别是以局部肿块为首发症状而就诊的白血病。各类白血病髓外浸润以原始细胞增生为主者,均需与非霍奇金淋巴瘤鉴别。

关 键 词:髓外浸润  诊断  FNAC  髓性白血病  CML  AML  临床  原始细胞  细胞病理学  增生
文章编号:1007-8096(2004)05-0334-03
修稿时间:2004年2月8日

Diagnosis of extramedullary infiltration of leukemia by fine needle aspiration cytopathology
Abstract:Objective To improve the diagnostic accuracy of the extramedullary infiltration of leukemia, which was a problem in diagnosis by fine needle aspiration cytopathology (FNAC). Methods We analyzed the diagnostic results of FNAC from 33 cases of the extramedullary infiltration of leukemia. Results In the 33 cases, there were 23 cases of acute myelogenous leukemia (AML), and 10 cases of chronic granulocytic leukemia (CML). The average age of the patients with the extramedullary infiltration of AML was 29.7, in which 69.6% were adults. All the patients of the extramedullary infiltration of CML were older than 20, whose average age was 37.5. The most infiltrated site was lymph node, which accounted for 78.8%. Conclusion The pathological diagnosis of extramedullary infiltration of leukemia by FANC should be combined with clinical examination and some related laboratory test. It is easy to confuse some kinds of leukemia, especially in the patients whose initial symptom is local mass. All sorts of leukemia, whose extramedullary infiltration is the proliferation of mainly primitive cells, should be differentiated from non-Hodgkin's lymphoma.
Keywords:Eextramedullary infiltration  Leukemia  Diagnosis  Cytopathology
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