【摘要】 目的 探讨髓系肉瘤的临床特点、免疫学表型、诊断、治疗及预后。方法 回顾性分析6例髓系肉瘤患者的临床资料、诊断及治疗方案,并对患者进行随访。结果 6例髓系肉瘤患者中男2例,女4例,2例患者以发现右乳肿块及腹壁包块起病,余4例临床表现分别为头痛、鼻塞、双下肢麻木、腹痛。细胞形态学特点:肿瘤细胞弥漫浸润,细胞核圆至折叠核,可见核仁,染色质细腻,可见少量散在嗜酸性粒细胞。免疫组化不同程度表达髓过氧化物酶(MPO)、CD34、CD43、CD99、CD117、Ki-67。随访期内4例伴急性白血病患者分别于确诊后8个月、2个月、7个月、2个月死亡,1例为初诊患者,现存活,另1例失访。结论 髓系肉瘤是一种罕见的、预后差的髓系形态学及免疫表型特征的恶性肿瘤,需根据临床表现、实验室检查、病理形态学及免疫组化检查予以诊断,并采用系统性化疗联合手术或放疗治疗方案。更多还原

【Abstract】 Objective To explore the clinical features, immunophen otype, diagnosis, treatment and prognosis of myeloid sarcoma. Methods Clinical data, diagnosis and treatment of 6 patients with myeloid sarcoma were analyzed betrospectively and the prognosis of the patients were followed up. Results Among 6 cases of patients with myeloid sarcoma, there were 2 males and 4 females. Two cases were found with the mass of right breast and abdomen,while the clinical manifestations of other 4 patients were headache,nasal congestion, numbness of the lower limbs and abdominal pain. The morphological characteristics were represented as diffusive infiltration of tumor cells, folded nucleus, visible nucleoli, chromatin fine and a small amount of scattered eosinophils. The immunohistochemical study showed that cases were positive for myeloperoxidase(MPO),CD34,CD43,CD99,CD117 and Ki-67. During the follow-up,4 cases with acute leukemia died at 8,2,7,2 months after diagnosis,respectively,one case with primary diagnosis still lives now and one case was lost. Conclusion Myeloid sarcoma is a rarely occurred malignance with high rate of poor prognosis with morphological characteristics and immunophenotypes of myeloid cells. The clinical manifestations,laboratory examination,pathology tests and immunochemistry are needed for its diagnosis.Systematic chemotherapy combined with surgery or radiotherapy can be used in its treatment.更多还原