以乳腺肿物为首发或复发表现的成人急性淋巴细胞白血病诊治分析：附病例报告

Breast Lump as An Initial or Relapse Manifestation in Adult Acute Lymphoblastic Leukemia:Diagnosis and Treatment

目的探讨以乳腺肿物为首发或复发表现的成人急性淋巴细胞白血病(ALL)的临床特点、诊疗方法和治疗效果,以提高对该病的认识,避免误诊。方法收集我院4例以乳腺肿物为首发或复发表现的成人ALL的临床资料并结合相关文献加以分析。结果 4例患者无血液系统症状或症状较轻,无其他常见结外器官受累,乳腺粗针穿刺可及时诊断,给予化疗或异基因移植后,治疗反应尚可。结论以乳腺肿物为首发或复发表现的成人ALL不容忽视,乳腺粗针穿刺方便易行,结合骨穿等血液学检查可快速诊断,避免误诊,不提倡手术及放疗,宜采用化疗及造血干细胞移植治疗。

Objective This study was aimed to discuss clinical features,diagnostic and therapeutic method,and efficacy of adult acute lymphoblastic leukemia patients with breast lump as an initial or relapse manifestation,so as to improve understanding of this disease and avoid misdiagnosis.Methods The clinical information of four cases of adult acute lymphoblastic leukemia with breast lump as an initial or relapse performance was collected and analyzed,and the related literature was reviewed for further discussion.Results The results indicated that the hematological symptoms of these four patients were mild or even normal with none of other common isolated extra-nodal organs sites being involved.Fine needle aspiration was the timely diagnostic method and the patients had good therapeutic responses to standard chemotherapy or HSCT.Conclusion Adult acute lymphoblastic leukemia with breast lump as an initial or relapse manifestation should not be ignored.Fine needle aspiration is easy to operate,which,coupled with bone marrow aspiration,could provide an accurate and prompt diagnosis,and avoid misdiagnoses.Surgery and radiotherapy not being recommended,chemotherapy and HSCT should be a preferred therapeutic method for this kind of patients.