含Auer小体样物质的非髓系肿瘤细胞临床与实验室特点分析

Characteristic of Auer rod-like inclusions in the cytoplasm of non-myeloid neoplasm cells

目的回顾分析2例胞浆中含Auer小体样物质的非髓系肿瘤细胞(急性T淋巴母细胞性淋巴瘤/白血病,脾脏淋巴瘤),进一步探讨Auer样物质与真正Auer小体的形态学特点、性质以及在血液疾病诊断中的价值,以提高临床与实验室人员对其的认识。方法分析2例非髓系肿瘤细胞的临床与骨髓细胞形态学、组化染色、免疫表型与遗传学结果,结合相关文献分析肿瘤性淋巴细胞胞浆中Auer小体样物质的性质。结果 2例非髓系肿瘤细胞免疫表型、活检组化染色结果均符合淋系肿瘤的特征;在形态学上Auer小体样物质与真正Auer小体相似,其中1例 Auer小体样物质出现在原始细胞中时,很难与真正的Auer小体进行区分。结论 Auer小体是髓系与非髓系肿瘤鉴别诊断、以及骨髓增生异常综合征(MDS)分型中重要的形态学依据,但少数非髓系肿瘤也会出现Auer样物质,血液肿瘤的准确诊断必须依靠流式细胞分析、组化染色、遗传与分子生物学检查综合判断。

Objective To report 2 cases of Auer rod-like inclusions in the cytoplasm of non-myeloid neoplasm(acute T lymphoblastic lymphoma/leukemia and splenic lymphoma) cells. To investigate the morphological characteristics of Auer rod and Auer rod-like inclusions. Methods The 2 cases of non-myeloid neoplasm were diagnosed by morphology,immunohistochemical staining,immunophenotype and cytogenetic analysis. Literature review was performed. Auer rod-like inclusions in the cytoplasm of non-myeloid neoplasm cells were evaluated. Results The results of immunohistochemical staining and immunophenotype were compatible with lymphoid neoplasm. For the 2 cases,the morphological characteristics of Auer rod-like inclusions and Auer rod were similar,especially in 1 case of Auer rod-like inclusion appearing in lymphoblast cell,and it was difficult to distinguish Auer rod-like inclusion and Auer rod. Conclusions Auer rod is a cytological marker of myeloid neoplasm,and it is critical in myelodysplastic syndrome(MDS) classification. However,Auer rod could be infrequently found in non-myeloid neoplasm cells,so it should be carefully revaluated not only by morphology,but also by immunohistochemical staining,immunophenotype and cytogenetic analysis.