Chronic neutrophilic leukemia--report of a case and review of the literature

A male patient, aged 78, was found with chronic neutrophilic leukemia (CNL). The patient showed sustained mature neutrophilic leukocytosis, splenomegaly, a high leukocyte alkaline phosphatase score, elevated serum vitamin B12 and uric acid, myeloid hyperplasia and absence of ph' chromosome in the bone marrow, with no evidence suggesting this condition to be a leukemoid reaction to an underlying disease. In addition to the above mentioned features, some functional characteristics of CNL cells were compared with normal cells. CNL is a very rare disease; some thought it as a variant of chronic myelogenous leukemia (CML). In this report a review of the literature is also included.     

卵巢成熟性囊性畸胎瘤恶变临床病理分析及人类乳头瘤病毒检测

目的：分析卵巢成熟性囊性畸胎瘤恶变的临床病理学特征及其与人类乳头瘤病毒感染的关系。方法：回顾性研究了１４例卵巢成熟性囊性畸胎瘤恶变临床及病理学特征,并且应用ＰＣＲ技术对其中７例的瘤体组织及宫颈组织进行了人类乳头瘤病毒检测。结果：１４例卵巢畸胎瘤恶变病例发病年龄为３０～８２岁（平均６１．７岁）,组织学类型包括鳞状细胞癌（１１例）、腺癌、甲状腺乳头状腺癌及甲状腺类癌（各１例）。人类乳头瘤病毒检测没有发现阳性病例。结论：卵巢成熟性囊性畸胎瘤恶变是一种少见的病变,发病年龄以绝经后妇女为主,组织学类型以鳞状细胞癌最为多见,未发现ＨＰＶ感染与其的关系。     

慢性中性粒细胞白血病27例临床分析

目的：探讨慢性中性粒细胞白血病(CNL)的诊断、治疗和预后。方法回顾性分析1985-2015年我院收治的27例CNL患者的实验室特点、治疗方法和预后。结果27例CNL患者血液中中性粒细胞持续增多,平均40.7×109/L,骨髓粒细胞系增生并以成熟中性粒细胞为主,杆状核粒细胞占(21.1±8.0)%,分叶核粒细胞占(44.4±17.1)%,中性粒细胞碱性磷酸酶(NAP)积分增高平均235.0分,绝大多数患者骨髓红细胞系统明显受抑;25例患者使用马利兰或羟基脲治疗后症状有所改善、脾脏缩小及血液中白细胞数下降;2例疗效不佳,仍然有中性粒细胞增多及脾肿大。结论 CNL是一种罕见类型的慢性白血病,以骨髓成熟中性粒细胞浸润为特点,化疗和酶抑制剂等疗法对其有一定作用。     

Hepatocellular carcinoma presenting as neutrophilic leukaemoid reaction--a rare entity

Leukaemoid reaction is a rare, growth factor-driven, paraneoplastic manifestation of hepatocellular carcinoma. It may masquerade as the neutrophilic chronic myeloid leukaemia or as chronic neutrophilic leukaemia. A 52-year-old male presented with hepatosplenomegaly and severe leucocytosis. He had progressive leucocytosis, neutrophil alkaline phosphatase score elevated, liver function tests altered. FNAC from the mass in the liver revealed features of moderately differentiated hepatocellular carcinoma. The patient deteriorated within two weeks and died thereafter.     

慢性髓系白血病初诊患者M-bcr/abl与m-bcr/abl融合基因转录子共表达的临床意义

目的探讨慢性髓系白血病（CML）初诊患者M-bcr／abl与m-ber／abl融合基因转录子共表达的临床意义。方法对111例初诊CML患者抽取骨髓，分离单个核细胞后，使用巢式PCR检测m-ber／abl融合基因转录子的表达。结果111例CML患者M-bcr／abl和m-ber／abl共表达率为51．4％；共表达与单M-ber／abl阳性的初诊CML患者相比在血红蛋白浓度、白细胞数、中性粒细胞碱性磷酸酶（NAP）比例及积分、Ph染色体比例和肝脾肿大均无差异，仅血小板数差异有统计学意义（P〈0．05）。b3a2型共表达患者血小板数比单M-ber／abl阳性患者高（P〈0．05）；b2a2型共表达和单表达患者比较差异均无统计学意义。有2例患者阴茎异常勃起，均为m-ber／abl阴性CML患者。结论共表达m-ber／abl的b3a2型初诊CML患者易有血小板数增高；共表达m-bcr／abl对b2a2型初诊CML患者的临床表现无影响。     

A case of chronic granulocytic leukemia in a dog.

A case of chronic granulocytic leukemia was diagnosed in a ten year old miniature poodle and was observed for four and one half years. Methods of diagnosis and characteristic features are described. A persistent granulocytosis with a preponderance of mature forms and the absence of a detectable underlying pyogenic process were key diagnostic features which enabled distinction of this neoplastic process from acute granylocytic leukemia and a leukemoid reaction. Other features included dysplastic granulocytes in various developmental stages, marginal anemia and hyperplastic bone marrow (myeloid elements). No blast crisis occurred. This dog was euthanatized in August 1975.     

慢性中性粒细胞白血病

目的慢性中性粒细胞性白血病是一种非常罕见的骨髓增生性肿瘤,既往诊断标准无特异性,治疗效果差,预后不良。新近发现CSF3R和SETBP1基因突变,为本病的诊断和预后判断提供了特异的敏感的分子生物学标记,同时,也为开辟新的治疗途径奠定了基础。     

坏疽性脓皮病6例临床分析

坏疽性脓皮病(Pyoderma gangrenosum)是一种罕见而凶险的以皮肤坏疽性溃疡为特征的皮肤病,国内文献报道近20例,大多为个案报告,现将本院10年来收治的6例报告如下。     

Scanning electronmicroscopy of hypertrophic and keloid scar

The scanning electronmicroscopic appearances of hypertrophic and keloid scar before and after treatment, mature scar and normal skin have been investigated. There is a graduation of features such as collagen orientation and fibre size which accompanies the clinical maturation from the active hypertrophic state into mature scar, a process which is hastened but not materially altered by treatment with steroid or compression-occlusion.     

腹腔镜手术治疗卵巢成熟型畸胎瘤106例临床分析

目的 分析经腹腔镜手术治疗的卵巢成熟型畸胎瘤病例的临床特点.方法 对106例经腹腔镜手术治疗的卵巢成熟型畸胎瘤患者的临床资料进行回顾性分析.结果 106例患者均在腹腔镜下完成手术,无严重并发症发生.彩色多普勒超声诊断符合率为98.11%（104/106）.手术中畸胎瘤破裂组比未破裂组手术时间长、出血量多,两组比较差异有统计学意义（P〈0.05或P〈0.01）;而术后复发率、术后妊娠率两组比较差异无统计学意义（P〉0.05）,术中行对侧卵巢剖探25例,未见异常.对侧卵巢剖探对术后妊娠率的影响与未行剖探组（81例）比较差异无统计学意义（P〉0.05）.结论 腹腔镜手术治疗卵巢成熟型畸胎瘤技术成熟,安全可靠.术中畸胎瘤破裂对术后复发率、术后妊娠率未见明显影响.对侧卵巢剖探并不需要常规进行.