Objective: To discuss diagnosis and treatments of acute monocytic leukemia with subcutaneous nodules and testicular infiltration as initial manifestations. Methods: Clinical records of a patient with acute monocytic leukemia (M5b) presented with subcutaneous nodules and testicular infiltration as initial symptoms were analyzed retrospectively and the literatures were reviewed. Results: A 47-year-old male patient diagnosed as acute monocytic leukemia was received 4 courses of chemotherapy in succession with MA, IA, VMCPE and VMA, and was not reached complete remission bone marrow, eventually gave up treatments and died after discharging from hospital. Conclusion: Leukemias presented with subcutaneous nodules and testicular infiltration as initial manifestations are easy to be misdiagnosed, patients combined with extramedullary infiltration usually have poor efficacy and prognosis, and stronger chemotherapy or allogeneic hematopoi -etic stem cell transplantation should be performed on these patients.%目的:探讨以皮肤结节、睾丸浸润为首发症状的急性单核细胞白血病的诊断和治疗原则.方法:回顾性分析1例以皮肤结节、睾丸浸润为首发症状的急性单核细胞白血病(M5b型)患者的临床资料,结合文献复习.结果:1例47岁男性患者,诊断为急性单核细胞白血病,先后予MA、IA、VMCPE及VMA共4个疗程化疗,骨髓一直未达完全缓解,后患者放弃治疗,出院后死亡.结论:以皮肤结节、睾丸浸润为首发症状的白血病易误诊,急性白血病合并髓外浸润者疗效及预后差,应采用更强烈的化疗方案或异基因造血干细胞移植治疗.
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