Acute unclassified leukemia. A clinicopathologic study with diagnostic implications of electron microscopy
Acute unclassified leukemia. A clinicopathologic study with diagnostic implications of electron microscopy
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急性未分类白血病。
DOI：
10.1002/ajh.2830090109
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发表时间：
1980
影响因子：
12.8
通讯作者：
A. Cork
中科院分区：
文献类型：
--
作者：
E. Youness;J. Trujillo;M. Ahearn;K. McCredie;A. Cork
根据严格的细胞学和细胞化学标准，22例患者被诊断为急性和未分化白血病。根据定义的标准，白血病细胞不能被用于造血组织研究的常规光显微镜技术分类。在新鲜骨髓样本上进行细胞化学研究，包括过氧化物酶、周期性酸希夫（PAS）和非特异性酯酶（α -丁酸萘酯反应酯酶）染色，并在200个细胞上测定每种染色的阳性白血病细胞百分比。在这一系列的白血病中，光镜下的细胞化学对进一步分类没有帮助。随后对这些患者骨髓样本的电镜检查证实了白血病细胞的不成熟和核/细胞质的不同步。在这些细胞中可以看到几种体内肿瘤标志物，如核泡、核体增加和细胞质纤维束。其中14例在超微结构水平上表现出过氧化物酶阳性的发育性颗粒形成，并被重新分类为急性粒细胞白血病（AGL）。1例被重新分类为淋巴瘤（低分化型），1例被诊断为急性单核细胞白血病（AMonoL）， 6例仍未分化（AUL）。对这些患者的临床和实验室特征、治疗反应和生存数据进行评估。本研究证明电子显微镜在人类白血病的细胞学诊断中是有用的。
By rigid cytological and cytochemical criteria, the diagnosis of acute and undifferentiated leukemia was established in 22 patients. According to defined criteria, the leukemic cells could not be classified by conventional light microscopic techniques employed in the study of hematopoietic tissue. Cytochemical studies including peroxidase, periodic acid schiff (PAS) and nonspecific esterase (alpha napthyl butyrate‐reacting esterase) stains were done on fresh bone marrow samples, and the percentage of positive leukemia cells for each of these stains was determined on 200 cells. In this series of leukemias, cytochemistry at the light microscope level did not contribute to further classification. Subsequent electron microscopic examination of bone marrow samples from these patients confirmed the immaturity and nuclear/cytoplasmic asynchrony of the leukemic cells. Several in vivo neoplastic markers, such as nuclear blebs, increased nuclear bodies, and cytoplasmic fibrillar bundles could be demonstrated in these cells. Fourteen cases from this series exhibited peroxidase‐positive developmental granule formation at the ultrastructural level and were reclassified as acute granulocytic leukemia (AGL). One case was reclassified as lymphoma (poor differentiated type), one case was diagnosed as acute monocytic leukemia (AMonoL), and six cases remained in the undifferentiated category (AUL). Clinical and laboratory features, response to treatment, and survival data were evaluated for these patients. This study demonstrated that electron microscopy is useful in the cytological diagnosis of human leukemia.