【摘要】 目的 :用细胞化学染色的方法诊断恶性淋巴瘤骨髓累及并与白血病相鉴别。方法 :细胞化学染色方法。结果 :前躯淋巴母细胞性淋巴瘤 (PL B)、中心小裂细胞性淋巴瘤 (S- FCC)和伴毛细胞的脾淋巴瘤 (SL VC) POX、SBB和 CE均为阴性。PAS:S- FCC和 SL VL 反应弱 ,PL B反应较强。淋巴瘤珠状占 2 2 .2 2 %。AL L 珠状占 70 .5 9%。NAE:S- FCC反应强度以 + +为主 ,SL VL 和 PL B较弱。ACP:S- FCC较 SL VC和 PL B略强 ,S- FCC和 SL VC均可见 + + + +。TRAP:S- FCC阳性率 2 %～ 5 4% ;PL B阳性率 10 %～ 16 % ;SL VC阳性率均为 18%。真性组织细胞性淋巴瘤 (THL) ACP4例均为阳性 ,阳性率为 10 0 % ,1例 TRAP阳性。淋巴瘤与 CL L、HCL 和 AL L 相比较发现 ,淋巴瘤较 CL L 和 AL L TRAP明显增高 ,S- FCC和 SL VC的 ACP和 TRAP与 HCL 相同。结论 :细胞化学染色在诊断淋巴瘤骨髓转移 ,并与 AL L 和 CL L 相鉴别上有一定意义 ,淋巴瘤骨髓累及 PAS阳性率和阳性指数较 AL L 弱。ACP阳性较 AL L 和 CL L 强 ,具有较强的抗酒石酸的功能 ,但与 HCL 难鉴别。更多还原

【Abstract】 Objective:To diagnose lymphomas with bone marrow infiltration and differentiate from leukemias using cytochemical staining methods.Methods:Cytochemical staining.Results:POX,SBB and CE are all negative in precusor B cell lymphoblastic lymphoma(PLB),follicular center small cleaved cell lymphoma (S FCC)and splenic lymphoma with villious lymphoct(SLVL).For POX,it shows a faint reaction in S FCC and SLVL,fine and middle granules are usual.Strong reaction in PLB can be seen,(44.4% of patients show big granules and 22.2% show bead granules.Acute lymphoblastic leukemia(ALL) patients have low PAS positive rate,but high positive index,70.6% patients show bead granules.For NAE,46% of S FCC patients are positive,+～++ intensity are usual.It is faint in SLVL and PLB.For ACP,S FCC patients show stronger reaction than SLVL and PLB patients.++++ intensity can be seen in both S FCC and For TRAP,37.5% of S FCC patients are positive,percentage of positive cell is 2%to 54%.It is 22.2%(positive cell 10% to 16%)in PLB,66.7%(positive cell 18%)in SLVL.POX,SBB and CE all show faint reaction in true histiocytic lymphoma(THL),NSE reaction is stronger in some THL patients.ACP is positive in all 4 cases,TRAP is positive in only one patients.Positive rate of TRAP in lymphoma is higher than that in chronic lymphocytic leukemia(CLL) and ALL.S FCC and SLVL patients show the similar ACP and TRAP reaction to hairy cell leukemia(HCL).Conclusion:There is a significant role for cytochemical staining in the diagnosis of lymphomas with bone marrow infiltration and differentiation from ALL and CLL.Patients of lymphoma with bone marrow infiltration show fainter PAS reaction than ALL.But they show stronger ACP reaction than ALL and CLL,have stronger tartrate resistant acid phosphatase activity.It is difficult to differentiate from HCL.更多还原