316例淋巴组织肿瘤骨髓细胞形态学的WHO分型观察

Cytomorphological feature on bone marrow samples in 316 cases of Tumous of Lymphoid Tissues:According to WHO Classification

目的:观察淋巴系肿瘤在骨髓细胞形态学中的表现,探讨WHO分型有关问题。方法:采用WHO分型方法, 对316例伴有骨髓细胞形态学表现异常的淋巴组织肿瘤进行分析。结果:前体B、T淋巴母细胞急性白血病(ALL)占46.6%, 外周B淋巴组织肿瘤中慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)占18.4%,多发性骨髓瘤(MM)占14.6%,其他 恶性淋巴瘤细胞骨髓浸润亦较多见,占12.2%,浸润程度不一。其余比例较少的疾病为Burkitt淋巴瘤/白血病、毛细胞白血 病(HCL)、幼稚淋巴细胞白血病(PLL)、浆细胞白血病(PCL)、伴有绒毛淋巴细胞的脾淋巴瘤(SLVL)。B淋巴系肿瘤病例较T 淋巴组织肿瘤明显增多。结论:WHO分型以细胞形态学和免疫分型为基础,确定主要分化类型和分化程度,并结合细胞遗传 学异常以及特殊的病因学和临床特点综合分类,可能是目前国际上最为合理的分类法。

Objective:To investigate the WHO classification through cytomorphological feature on bone marrow samples in patients with tumous of lymphoid tissues.Methods:We utilized WHO classification to investigate abnormal morphological presentation on bone marrow sample in 316 patients with lymphocytic neoplasms.Results:Precursor-B and -T acute lymphoblastic leukemia accounted for 46.6% of lymphocytic neoplasms;Among peripheral B-cell lymphocytic neoplasms,chronic lymphocytic leukemia/small lymphocytic lymphoma held up to 18.4%;Multiple myeloma 14.6%;and 12.2% belonged to other malignant lymphoma with variable BM infiltration.The other rare disorders involved Burkitt lymphoma/leukemia,hairy cell leukemia,prolymphocytic leukemia,plasma cell leukemia,splenic lymphoma with villous lymphocytes.Taken together,patients suffered more from B-cell lymphocytic disorders than T-cell disorders.Conclusion:WHO classification is established on the cytomorphological and immunohistochemical analysis to ascertain the main differentiation extent,and further confirmed by the support of cytogenetic abnormal manifestation,specific etiology and clinical evidence.