Acute leukemia of adults. Ultrastructural, cytochemical and histologic observations in 100 cases.
Acute leukemia of adults. Ultrastructural, cytochemical and histologic observations in 100 cases.
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成人急性白血病。
DOI：
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发表时间：
1980
影响因子：
3.5
通讯作者：
Robert D. Collins
中科院分区：
文献类型：
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作者：
Alan D. Glick;Kamala Paniker;J. M. Flexner;Stanley E. Graber;Robert D. Collins
为建立急性白血病的分型标准，对100例成人白血病进行了骨髓组织学、特殊染色和电镜检查。对每种染色进行分类计数，并将结果与电子显微镜获得的结果结合起来进行最终分类。髓系（非淋巴样）白血病最常见（83例），淋巴样白血病13例，红白血病2例，未分化白血病2例。骨髓颗粒的组织学研究揭示了淋巴细胞、浆细胞和异常红细胞成分的显著混合物，特别是在急性粒单核细胞白血病中。在90%的病例中，细胞化学结果的解释得到了超微结构研究的证实。细胞化学和超微结构解释之间的临床显着差异很少被发现。只有两个髓系和五个淋巴样的情况下，没有标记典型的任何细胞化学染色。单一的最可靠的特殊染色是高碘酸-希夫染色，而最难解释的染色是α-醋酸萘酯酶染色。苏丹黑染色对显示奥尔杆特别有帮助。6例细胞化学未分类的病例中有5例通过电子显微镜进行了分类。虽然每种类型的白血病的细胞化学染色模式，显着的组内变化的细胞化学反应被确认。这项研究表明，超微结构检查应常规用于分类的情况下，可疑的细胞化学结果和分析未分类的情况下。
In order to establish guidelines for categorization of acute leukemia, marrow histology, special stains, and electron microscopy were performed in 100 adult leukemia cases. Differential counts for each stain were performed, and the results were combined with those obtained by electron microscopy for final classification. Myeloid (non-lymphoid) leukemia was most common (83 cases), and there were 13 lymphoid cases, two cases of erythroleukemia, and two undifferentiated leukemias. Histologic studies of marrow particles revealed significant admixtures of lymphocytes, plasma cells, and abnormal erythroid elements, particularly in acute myelomonocytic leukemia. Interpretations of cytochemical results were confirmed by ultrastructural studies in 90% of the cases. Clinically significant discrepancies between cytochemical and ultrastructural interpretations were rarely found. Only two myeloid and five lymphoid cases did not mark typically with any cytochemical stain. The single most reliable special stain was the periodic acid-Schiff stain, whereas the stain most difficult to interpret was the alpha-naphthyl acetate esterase stain. Sudan black stain was particularly helpful in demonstrating Auer rods. Five of six cases unclassified by cytochemistry were categorized by electron microscopy. Although patterns of cytochemical staining were delineated for each type of leukemia, significant intragroup variation in cytochemical reactions was recognized. This study indicates that ultrastructural examination should be routinely used for categorization of cases with equivocal cytochemical findings and for analysis of unclassified cases.