大颗粒淋巴细胞白血病细胞免疫学表型分析

Immunology phenotype analysis of the cell of the large granular lymphocyte leukemia

目的:分析大颗粒淋巴细胞白血病(LGLL)细胞的免疫学表型。方法:取3例LGLL患者的外周血和骨髓液涂片,采用流式细胞术对其免疫学表型进行分析,同时用瑞-姬混合染色和髓过氧化物酶(MPO)、过碘酸-雪夫反应(PAS)等细胞化学染色对其进行观察。结果:3例白血病细胞形态均呈原始、幼稚淋巴细胞样,胞浆内有数量较多的或大或小的紫红色颗粒,MPO染色和PAS反应均为阴性。3例LGLL均表达CD56,其中1例还表达CD3,为T细胞型LGLL;另2例不表达CD3,为NK细胞型LGLL。T细胞型LGLL型患者白血病细胞同时表达B细胞抗原CD20。结论:通过免疫学表型分析可以区分T细胞和NK细胞型LGLL,LGLL细胞存在抗原表达紊乱的现象。

Aim： To study the feature of immunology phenotype of large granular lymphocyte leukemia （LGLL） cells. Methods ： Three cases of LGLL were subjected to analyzed the immunology phenotype on FCM, and cell morphology was observed at the same time. Results： There were a fairly large number of mauve granules in the cytoplasm of lymphoblast and prolymphocyte; some granules were relatively thick and some slightly thin. There were negative reactions of the marrow peroxide enzyme （MPO） and periodic acid-Schiff reaction （PAS） at the same time. Among the 3 cases of LGLL 1 case was T cell type and 2 cases were NK cell type. All the leukemia cells expressed CD56; T cell type LGLL also expressed CD3, and B cell antigen CD20 but NK cell type LGLL did not. Conclusion ： LGLL leukemia cells have mauve granules, but the origin of the T cell and NK cell can be distinguished by phenotype analysis. There is a disordered antigen expression in LGLL leukemia cells.