T细胞前淋巴细胞白血病转ALK阴性间变性大细胞淋巴瘤一例

A case of T cell prolymphocytic leukemia transforming to ALK-negative anaplastic large cell lymphoma

目的报道1例T细胞前淋巴细胞白血病(T-PLL)转变为间变性淋巴瘤激酶(ALK)阴性的间变性大细胞淋巴瘤(ALCL,ALK-),并进行文献复习。方法采用MIC标准诊断。形态学检查包括骨髓涂片(瑞特染色法)、胸水涂片,细胞块、淋巴结活检、免疫化学染色;R显带技术进行细胞遗传学分析;多色流式细胞仪分析免疫表型。结果该患者以T-PLL起病,骨髓中异常细胞表型:CD2+、CD3+、cCD3+、CD4+、CD7+、CD8-、CD10-、HLA-DR+、cTDT-、TCRα/β+,CD38、CD5部分阳性。染色体核型:46,XX。6个月后确诊为ALCL,染色体核型:94,XXX,-X,1q-x2,+3mar。结论 T-PLL可转变为ALCL,ALK-。

Objective To report a case of T cell prolymphocytic leukemia（ T-PLL） transforming to anaplastic lymphoma kinase（ ALK）-negative anaplastic large cell lymphoma（ ALCL,ALK-）,and to review the literatures.Methods The MIC criteria was adopted. Morphology included bone marrow smear（ wright staining）,pleural effusion smear and cell block,lymph node biopsy,cell chemical dyeing. R banding technique was used in cell genetics analysis,and the immuno-phenotype was analyzed by multicolor flow cytometry. Results The patient was onset as T-PLL,and the abnormal phenotypes in the bone marrow were CD2^＋,CD3^＋,cCD3^＋,CD4^＋,CD7^＋,CD8-,CD10^-,HLADR^＋,cTDT^-,TCRα/β^＋ and CD38,CD5 partly positive. Karyotype analysis showed 46,XX. After 6 months,abnormal phenotypes had been changed into ALCL,and karyotype analysis showed 94,XXX,-X,1q-x2,＋ 3mar.Conclusions T-PLL can transform into ALCL,ALK^-.