毛细胞白血病的电子显微镜诊断与鉴别诊断(附8例分析)

The Ultra-structural Features of Hairy Cell Leukemia in differential Diagnosis-8 cases report

目的：研究毛细胞白血病（HCL）细胞超微病理结构，总结电子显微镜的诊断和鉴别诊断要点。方法：分离8例HCL患者骨髓有核细胞，透射电镜观察毛细胞超微结构。结果：HCL细胞大多数为圆形或卵圆形，直径8～14μm，核圆，异染色质块状边集；细胞质中高尔基氏体和粗面内质网中度发达，核糖体丰富，糖原较少，5例HCL中有髓样结构。所有病例表面都存在绒毛或突起，其中6例短粗，属分枝型，2例为细长微绒毛，属细长型。8例中只有2例细胞质有核糖体板层复合结构（RLC）。结论：细胞整体轮廓和表面微绒毛是HCL超微结构诊断的莺要特征，核糖体板层复合结构在HCL细胞中特异性不强。

Objective ： To investigate the ultrastructural pathological features of hairy cell leukemia （HCL）, and summalize the points of diagnosis and differential diagnosis. Method：observing the hair cells （HCs） separated from bone marrows of 8 cases with HCL by transmission electron microscope （TEM）. Result; HCL cells （HCs） were nearly round or elliptical, with diameter around 8- 14μm. The contour of nucleus was oval shaped with more lump heterochromatins under submembrane. HCs usually contained moderately developed rough endoplasmic reticulum （rER）, Golgi bodies in medium size and plenty of free polysomes, but few glycogens. Meanwhile, 5 out of 8 cases were found to have myelin-like bodies in cytoplasm. All of HCs in 8 cases shared microvillus/processes on the cell surface, 6 cases with branched shape and 2 eases with fine hair-like shape. The ribosome-lamelle comple xes （RLC） were only found in 2 out of 8 cases. Conclusion： The integral contour of cell and mierovillus on HC＇s surface were the significant markervs in diagnosis of HI.C, but the RLC is not specific for TEM diagnosis.