合并骨髓坏死的髓系抗原及Ph染色体阳性B急性淋巴细胞白血病一例

Bone Marrow Necrosis as An Initial Manifestation of Philadelphia Chromosome and Myeloid Antigens Positive B Acute Lymphoblastic Leukemia——A Case Report

为加强对骨髓坏死(BMN)的病因及病理过程复杂性的认识,了解髓系抗原阳性(My+)及Ph染色体阳性(Ph+)的B急性淋巴细胞白血病(ALL)临床表现的多样性,报道分析了1例以BMN为首发症状的My+Ph+B-ALL并进行讨论。结果表明该病例临床特征复杂而多样,通过骨髓涂片和活检,免疫分型,染色体核型分析及FISH明确了诊断。积极治疗原发病改善了患者的预后。结论My+Ph+B-ALL并发BMN是一种罕见疾病,应采取多种方法检查明确诊断并积极治疗。

Many diseases cause bone marrow necrosis （BMN）, especially lymphocytic leukemia. To explore the complexity of the pathogenesis and pathology of BMN and understand the multiplicity of clinical features, a case of Philadelphia chromosome positive （ Ph ^＋ ） B acute lymphoblastic leukemia （ALL） expressing myeloid antigens was reported. The results indicated that the clinical features of this case were complicated and multiplex, the diagnosis was con firmed by using bone marrow smear and biopsy, immunopbenotype analysis, conventional cytogenttics and fluorescence in situ hybridization （ FISH）, the prognosis of patients improved by active treatment for primary disease. In conclusion, the Ph^＋ B ALL expressing myeloid antigen with BMN is very rare, its diagnosis should be confirmed by using multiple methods, and the active treatments should be performed.