血液病骨髓涂片中噬血细胞观察及其临床意义

The clinical significance and morphologic study of hemophagocyte from hemotologic patients.

目的 通过观察骨髓涂片中噬血细胞数量的改变,阐明噬血细胞在恶性淋巴瘤出现的临床意义。方法 观察 247例患者骨髓涂片中噬血细胞的数量;其中 32例恶性淋巴瘤, 75例贫血, 95例白血病, 45例红斑狼疮(SLE)。结果 淋巴瘤患者阳性 11例 (34. 4% )较白血病组 (2. 1% )、贫血组 (4. 0% )、红斑狼疮组 (6. 7% )明显增多(P<0.05),平均数 15. 8个较AL组 0. 3个,贫血组 0. 9个,SLE组 4. 8个明显增多。同时,有 6例噬血细胞阳性的淋巴瘤患者伴有异常的组织细胞出现。结论 噬血细胞增多对诊断ML相关的噬血细胞综合征有一定临床意义,对噬血细胞增多伴异常组织细胞出现的患者应高度怀疑淋巴瘤的可能。

Objective To investigate the change of hemophagocyte (Hem) in 247 patients,and to explore its clinical signiticance in lymophoma.Methods To observe Hem in bone marrow smears of 247 cases,including lymophoma 32 cases,leukemia 95 cases,anemia 75 cases,and SLE 45 cases.Results The Hem was positive in 11 cases out of 32 cases (34.4%)in lymophoma group,but another leukemia group only had 2 cases positive (2.1%),anemia group had 3 cases (4.0%),and STE group had 3 cases (6.7%).The positive rate of Hem in lymophoma was higher than the other three groups(P<0.05).The average number of Hem in each smear lymophoma was l5.8,which was also obviously higher than the other three groups(AL group 0.3,aenimia 0.9,and SLE 4.8).Mean while abnonnal histocytic were fo in 6 cases out of 32 cases lymophoma.Concusion Hemophagocytic hyperplasia has valuable clinical significance in making a diagnosis of reactive hemophagocytic syndrome that was related to lymothoma.Lymophoma should be suspected sudstan tially,when abnomal histocytic had been seen in bone marrow smears with hemophagocytic hyperplasia.