骨髓活检在慢性嗜酸性粒细胞白血病诊断与鉴别诊断中的意义

Clinicopathologic studies of 13 cases of chronic eosinophilic leukemia

目的探讨骨髓活检在慢性嗜酸性粒细胞白血病（CEL）诊断与鉴别诊断中的意义。方法回顾性分析13例CEL患者的临床特点，对其标本进行常规骨髓活检塑料包埋，通过H—G—E染色、网状纤维染色、甲苯胺蓝染色观察并分析组织切片的病理学特点。获得4例患者的随访资料。结果（1）13例CEL患者男：女为12：1。中位年龄40岁（23～67岁）。具有CEL的各种相关表现如发热、贫血、出血等，并可累及全身多个器官组织。（2）患者外周血嗜酸性粒细胞明显增高达（18．1±16．2）×10^9／L。（3）骨髓活检示嗜酸性粒细胞增生占绝对优势，其他各系如中性粒细胞、红系及巨核细胞相对减少。网状纤维染色（＋）6例，（2＋）4例，（3＋）3例。甲苯胺蓝染色可见少数肥大细胞散在分布。（4）随访4例患者目前病情平稳。结论结合CEL患者临床表现，骨髓活检在CEL的诊断与鉴别诊断中具有重要意义。

Objective To investigate the role of bone marrow biopsy （BMB） in diagnosis and differential diagnosis for chronic eosinophilic leukemia（CEL）. Methods Clinical and pathological features of thirteen CEL patients were analyzed retrospective. Routine histologic examination was performed on H-G-E, reticulin fiber and toluidine blue stained sections of plastic material emdedded samples of bone marrow biopsies. Results （1）The male-to-female ratio was 12： 1. The median age was 40 （23 -67 ） years old. They presented as fever, anemia, hemorrhage and so on. Most of organs and tissues were also be involved. （2） Peripheral blood counts characterized by eosinophilia （18. 1 ± 16.2） × 10^9/L, （3）BMB showed eosinophils were predominant components, others such as neutrophils, erythrocytes, megakaryocytes were decrease. Degree of reticular fiber was from（ 1 ＋ ）to（3 ＋ ）. （4）Follow-up information was available in only 4 patients , whose conditions were stable. Conclusion Combine with the clinical manifestations of CEL patients,it is important in diagnosis and differential diagnosis for CEL by observing the histomorphology features of bone marrow biopsy carefully.