骨髓活检在慢性嗜酸性粒细胞白血病诊断与鉴别诊断中的意义

目的 探讨骨髓活检在慢性嗜酸性粒细胞白血病(CEL)诊断与鉴别诊断中的意义.方法 回顾性分析13例CEL患者的临床特点,对其标本进行常规骨髓活检塑料包埋,通过H-G-E染色、网状纤维染色、甲苯胺蓝染色观察并分析组织切片的病理学特点.获得4例患者的随访资料.结果 (1)13例CEL患者男:女为12:1.中位年龄40岁(23～67岁).具有CEL的各种相关表现如发热、贫血、出血等,并可累及全身多个器官组织.(2)患者外周血嗜酸性粒细胞明显增高达(18.1 ±16.2)×109/L.(3)骨髓活检示嗜酸性粒细胞增生占绝对优势,其他各系如中性粒细胞、红系及巨核细胞相对减少.网状纤维染色(+)6例,(2+)4例,(3+)3例.甲苯胺蓝染色可见少数肥大细胞散在分布.(4)随访4例患者目前病情平稳.结论 结合CEL患者临床表现,骨髓活检在CEL的诊断与鉴别诊断中具有重要意义.

Clinicopathologic studies of 13 cases of chronic eosinophilic leukemia

OBJECTIVE: To investigate the role of bone marrow biopsy (BMB) in diagnosis and differential diagnosis for chronic eosinophilic leukemia (CEL). METHODS: Clinical and pathological features of thirteen CEL patients were analyzed retrospective. Routine histologic examination was performed on H-G-E, reticulin fiber and toluidine blue stained sections of plastic material emdedded samples of bone marrow biopsies. RESULTS: (1)The male-to-female ratio was 12:1. The median age was 40 (23-67) years old. They presented as fever, anemia, hemorrhage and so on. Most of organs and tissues were also be involved. (2) Peripheral blood counts characterized by eosinophilia (18.1 +/-16.2) x 10(9)/L, (3) BMB showed eosinophils were predominant components, others such as neutrophils, erythrocytes, megakaryocytes were decrease. Degree of reticular fiber was from (1+) to (3+). (4) Follow-up information was available in only 4 patients, whose conditions were stable. CONCLUSION: Combine with the clinical manifestations of CEL patients, it is important in diagnosis and differential diagnosis for CEL by observing the histomorphology features of bone marrow biopsy carefully.