嗜酸性粒细胞白血病浸润性巨脾1例报道及其临床病理特点分析

Megalosplenia infiltrated by eosinophilic leukemia:a case report and clinicopathologic analysis

目的:报道1例嗜酸性粒细胞白血病浸润性巨脾,结合文献探讨其临床及病理组织学特点。方法:对1例嗜酸性粒细胞白血病浸润性巨脾进行常规病理、免疫组化分析。结果:手术切除巨脾一个,体积35cm×20cm×8cm,切面呈红褐色,有多发性梗死灶。镜下可见脾正常组织结构破坏,脾小结消失,嗜酸性粒细胞弥漫浸润,以成熟型嗜酸性粒细胞为主,并可见较多幼稚嗜酸性粒细胞。免疫组化瘤细胞表达CD15(+),不表达CD5(-)、CD20(-)、CD30(-)、CD34(-)、CD45RO(-)。结论:嗜酸性粒细胞白血病十分少见,临床病理检查遇到巨脾时,应进行详细的组织病理学观察,避免误诊。

Objective：To study the clinical and pathological features of eosinophilic leukemia infiltrating spleen. Methods：One case of eosinophilic leukemia infiltrating spleen was investigated by histopathogical and immunohistochemical observation. Results：The cut surface of megalosplenia was fusco - rufous, with the size of 35cm ×20cm × 8cm and multiple infarct. Microscopically,the normal structure of spleen was disorganized, and splenic corpuscle disapeared. Eosinophile granulocytes, mainly mature types, were found to infiltrate widespreadly, moreover, more immature types also were found. In immunohistochemistry, the tumor cells were positive for CD15, but negative for CD5, CD20, CD30, CD34 and CD45RO. Conclusion： Eosinophilic leukemia was very rare. It should be observed carefully with histopathology in order to avoid misdiagnosis when a megalosplenia was found in clinical observation.