1024例恶性淋巴瘤外周血及骨髓的检测分析

Peripheral blood and marrow detection and analysis in 1 024 cases of malignant lymphoma

目的了解恶性淋巴瘤外周血表现和骨髓侵犯的概率,为淋巴瘤的早期诊断提供证据。方法对1 024例恶性淋巴瘤初诊患者外周血及骨髓涂片结果进行回顾性分析。结果经病理确诊的1 024例恶性淋巴瘤病例中血常规正常者744例,单纯红细胞减低者133例,红细胞合并白细胞减低者68例,红细胞、白细胞、血小板三系减低者49例,淋巴细胞增高者30例。骨髓涂片显示正常者788例,骨髓受侵犯者203例,合并白血病者33例。在236例受侵犯和合并白血病的病例中,非霍奇金氏淋巴瘤(NHL)占200例,而B细胞淋巴瘤占133例,T细胞占67例,霍奇金淋巴瘤(HL)仅占36例;淋巴瘤分期在1、2期的占788例,3、4期的占236例。结论淋巴瘤早期外周血往往表现正常,骨髓的受侵犯时外周血也可正常,而当淋巴瘤进入晚期时可合并白血病,早期的侵犯骨髓活检比涂片更具有诊断价值。

Objective To understand the representation of peripheral blood and the probability of bone marrow involvement in malignant lymphoma,to provide evidence for early diagnosis of lymphoma.Methods The peripheral blood and bone marrow smear results were performed the retrospective analysis in 1024 newly diagnosed cases of malignant lymphoma.Results Among 1024 cases of malignant lymphoma confirmed by pathology,744 cases had normal blood routine results,simple red blood cells（RBC） reduce was in 133 cases,RBC and white blood cells（WBC） reduce in 68 cases and RBC,WBC and PLT reduce in 49 cases.Lymphocytes were increased in 30 cases.788 cases of bone marrow smears showed normal,203 cases showed bone marrow involvement,33 cases showed complicating lymphoma cell leukemia.Among 236 cases of marrow involvement and complicating leukemia,200 cases were non-Hodgkin′s lymphoma（NHL） including 133 cases of B-cell lymphoma and 67 cases of T-cell lymphoma,and only 36 cases were Hodgkin′s lymphoma（HL）.788 cases of lymphoma were in phases 1 and 2,236 cases of lymphoma in phases 3 and 4.Conclusion The peripheral blood of early lymphoma is often normal,even when bone marrow involvement happening.Late lymphoma may be complicated with leukemia.In early marrow involvement,bone marrow biopsy has more diagnostic value than marrow smears.