摘要
目的:探讨以骨髓侵犯为首发表现的非霍奇金淋巴瘤(NHL)类型及实验室检查特点。方法:选取本院2010年1月-2019年7月以骨髓侵犯为首发表现的非霍奇金淋巴瘤患者81例,回顾性分析所有患者的临床特征及血常规、乳酸脱氢酶(LDH)、EB病毒结果、骨髓象特征、免疫分型类型、基因、遗传学特点等。结果:81例患者中,B细胞淋巴瘤73例(90%),T细胞淋巴瘤5例(6%),NK/T细胞淋巴瘤3例(4%)。套细胞淋巴瘤和弥漫大B细胞淋巴瘤分别为17例(21%)和16例(19.7%),淋巴浆细胞淋巴瘤7例(8.6%)。B症状者44例(54.3%),血象异常者65例(80.2%)。17例患者行基因检测,5例检出MYD88基因突变。25例行染色体检查,结果显示,检出t(8;14)(q24;q32) 5例、复杂核型3例、正常核型17例。EB病毒阳性者23例(28.4%),乳酸脱氢酶(LDH)增高者42例(51.9%)。骨髓淋巴瘤细胞比例占1%-92%,其中32例诊断为淋巴瘤白血病,6例骨髓淋巴瘤细胞出现类似髓外肿瘤细胞骨髓转移的成堆成团分布。结论:以骨髓侵犯为首发表现的NHL以B细胞淋巴瘤为主,病理类型以套细胞淋巴瘤和弥漫大B细胞淋巴瘤最多见,多伴血象异常;骨髓淋巴瘤细胞可出现成堆成团分布,不同类型的淋巴瘤细胞可做出方向性的诊断。
Objective: To investigate the types and laboratory characteristics of non-Hodgkin lymphoma( NHL) with bone marrow invasion as the first manifestation. Methods: 81 non-Hodgkin lymphoma patients with bone marrow invasion as the first manifestation treated in our hospital from January 2010 to July 2019 were selected. The clinical features,blood routine,lactate dehydrogenase( LDH),EB virus results,bone marrow features,immunophenotyping,gene and genetic characteristics of all patients were analyzed retrospectivel. Results: Among 81 patients,73 cases( 90%) were B-cell lymphoma,5 cases( 6%) were T-cell lymphoma and 3 cases( 4%) were NK/T-cell lymphoma,while the mantle cell lymphoma and diffuse large B-cell lymphoma were the highest,which accounted for 21%( 17 cases) and 19. 7%( 16 cases),and lymphoma accounted for 8. 6%( 7 cases). There were 44 cases( 54. 3%) showed B symptoms,65 cases( 80. 2%) showed abnormal blood routine. The MYD88 gene was detected in 5 of 17 cases. 25 cases of patients underwent chromosome examination,the result showed that 5 cases were t( 8;14)( q24;q32),3 cases were complex karyotype and 17 cases were normal karyotype. 23 cases( 23. 4%) were EB virus positive,42 cases( 51. 9%) were LDH increased. The proportion of bone marrow lymphoma cells was 1%-92%. Among them,32 cases were diagnosed as lymphoma leukemia,and 6 cases of bone marrow lymphoma cells showed mass distribution similar to extramedullary tumor cells with bone marrow metastasis. Conclusion: B-cell lymphoma is the predominant NHL with bone marrow invasion as the first manifestation,while mantle cell lymphoma and diffuse large B-cell lymphoma are the most common pathological types with blood routine abnormalities. Bone marrow lymphoma cells can also present clusters of bone marrow metastasis,different types of lymphoma cells can make directional diagnosis.
作者
林萍
黄荣富
谢若腾
张雅兰
庄伟煌
张学亚
LIN Ping;HUANG Rong-Fu;XIE Ruo-Teng;ZHANG Ya-Lan;ZHUANG Wei-Huang;ZHANG Xue-Ya(Department of Laboratory Medicine,The Second Affiliated Hospital of Fujian Medical University;Department of Hematology,The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,Fujian Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2021年第4期1148-1155,共8页
Journal of Experimental Hematology
