Chronic lymphocytic leukemia presenting with symptomatic central nervous system involvement.
Chronic lymphocytic leukemia presenting with symptomatic central nervous system involvement.
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慢性淋巴细胞白血病表现为中枢神经系统受累症状。
DOI：
10.1007/s00277-002-0475-2
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Finch,CN
中科院分区：
文献类型：
--
作者：
Akintola-Ogunremi,O;Whitney,C;Mathur,SC;Finch,CN
白血病浸润中枢神经系统（CNS）导致神经系统表现是慢性淋巴细胞白血病（CLL）的一种罕见并发症。此外，有症状的中枢神经系统受累作为先前未诊断的CLL的初始表现是极其罕见的。在本报告中，作者描述了一名89岁的女性先前诊断为阿尔茨海默病谁突然发展迅速恶化的精神变化。对脑脊液（CSF）上存在的淋巴细胞进行细胞学和免疫细胞学检查，发现克隆性B细胞淋巴增殖性疾病累及CNS，与表达κ轻链限制的新发B-CLL最一致。随后，对外周血淋巴细胞进行流式细胞术分析，证实了该患者的B-CLL诊断。因此，本研究表明，免疫细胞学评价的潜在用途，在检测单克隆淋巴细胞群体的CSF样本中的成年患者提出改变精神状态和CSF淋巴细胞增多。
Leukemic infiltration of the central nervous system (CNS) resulting in neurological manifestations is a rare complication of chronic lymphocytic leukemia (CLL). Furthermore, symptomatic CNS involvement as the initial presentation of previously undiagnosed CLL is extremely rare. In the present report, the authors describe a case of an 89-year-old female previously diagnosed with Alzheimer's disease who suddenly developed rapidly worsening mental changes. Cytological and immunocytological examinations of the lymphoid cells present on the cerebrospinal fluid (CSF) revealed CNS involvement by a clonal B-cell lymphoproliferative disorder, most consistent with de novo B-CLL expressing kappa light chain restriction. Subsequently, flow cytometric analysis done on the peripheral blood lymphocytes confirmed the diagnosis of B-CLL in this patient. Thus, this study shows the potential usefulness of immunocytological evaluation in detecting monoclonal lymphoid populations on CSF samples in adult patients presenting with altered mental status and CSF pleocytosis of lymphocytes.