[Plasma cell leukemia presenting with cleaved nuclei and a monocytoid appearance].
[Plasma cell leukemia presenting with cleaved nuclei and a monocytoid appearance].
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[浆细胞白血病表现为核分裂和单核细胞样外观]。
DOI：
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
K. Muta
中科院分区：
文献类型：
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作者：
N. Hirase;Shoichi Muta;Y. Abe;K. Muta
一位74岁男性，以贫血、血小板减少、白细胞增多为主要临床表现，41%的异常细胞有分裂核和单核细胞样核。骨髓中有43.6%的异常细胞浸润，过氧化物酶染色阴性，PAS染色阳性。表面抗原分析显示没有CD 2、3、4、8、10、19、20、13或33的表达。血清免疫电泳检测到一条单克隆带，可鉴定为kappa型伊加蛋白。免疫组化染色显示异常细胞中伊加和kappa型表达。该患者被诊断为浆细胞白血病，但形态学检查异常。表面抗原分析显示CD38表达较晚。本例提示，异常细胞的免疫染色是鉴别白细胞增多的浆细胞白血病所必需的。
A 74-year-old man presented with anemia, thrombocytopenia and leukocytosis with 41% abnormal cells having cleaved and monocytoid nuclei. The bone marrow was infiltrated with 43.6% abnormal cells that were negative for peroxidase staining and positive for PAS staining. Surface antigen analysis revealed no expression of CDs 2, 3, 4, 8, 10, 19, 20, 13 or 33. Serum immunoelectrophoresis detected a monoclonal band, which was identifiable as kappa-type IgA protein. Immunostaining also revealed expression of IgA and kappa-type in the abnormal cells. The patient was diagnosed as having plasma cell leukemia but the morphological findings were unusual. Surface antigen analysis revealed expression of CD38 later. This case suggests that immunostaining of abnormal cells is required for the differential diagnosis of plasma cell leukemia in leukocytosis.