表现异质的大颗粒淋巴细胞白血病6例临床分析

The heterogeneous of large lymphocytic leukemia：6 cases report and clinical analysis

目的提高对大颗粒淋巴细胞白血病（LGLL）的认识及鉴别诊断。方法对6例临床表现显著异质的LGLL的临床特征及实验室检查并结合文献进行临床分析。结果2例惰性T—LGLL和1例慢性NK—LGLL，临床呈慢性病程，主要表现为贫血和脾肿大，对治疗反应好；1例侵袭性T—LGLL及2例侵袭性NK—LGLL，临床以全身症状明显并有肝、脾肿大，预后极差。4种LGLL分别有各自的免疫表型特点。结论LGLL的诊断需结合临床、细胞学检测、免疫分型综合分析并加与鉴别诊断。

Objective To analyze and study the diagnosis of large granular lymphocyte leukemia（LGLL）. Methods To report and discuss six cases weth LGLL we have found. Results 2 of T-LGLL and lof NK-LGLL had indolent process, mainly presenting with anemia and splenomegaly and good response to treatment, while;1 of T-LGLL and 2 of NK-LGLL had aggressive process, their clinical characters are obviously general symptom, hepatomegaly, splenomegaly, these disease develop quickly and have bad prognosis. The immunophenotype of indolent LGLL is distinct from aggressive cases. Conclusion As a group of heterogeneous disease,its diagnosis should be based on clinical manifestation and immunophenotype and differentiated it carefully.