摘要:
Objective:To investigate characteristic diagnosis and differential diagnosis methods of hairy cell leuke-mia(HCL). Methods:The clinical features,peripheral blood and bone marrow smear,immunophenotyping,bone mar-row biopsy,immunohistochemistry and other laboratory findings of 13 patients with HCL were analyzed. Results:In these patients,there were 11 cases having different degree of hepatosplenomegaly. A different number of hairy lympho-cytes can be seen in the peripheral blood and bone marrow smears. The immunephenotype showed that 11 cases of classic HCL patients expressed CD19,CD20,CD22,CD123,FMC7,CD103,CD25,CD11c in the lymphocyte and 2 cases of variant type which did not express CD25 and CD11c. During the bone marrow biopsy,11 cases of patients with active bone marrow hyperplasia,and hair cells showed diffuse distribution,but 2 cases of bone marrow prolifera-tion decreased and the hair cells were nodular distribution. Immunohistochemistry showed that CD19,CD20,CD25, CD103,CD11c were positive,but CD23,CD38,CD5,CD10 were all negative,and the results were basically consistent with the results of flow cytometry. Conclusion:Bone marrow puncture,leukemia - immunotyping,bone marrow biopsy and immunohistochemistry in the diagnosis of HCL is of great significance,in addition,the immune typing can better i-dentify HCL and other chronic lymphocytic proliferative diseases.%目的:探讨毛细胞白血病(hairy cell leukemia,HCL)的临床特征及相关实验室诊断.方法:对13例HCL患者的临床特征、外周血和骨髓涂片、免疫分型、骨髓活检及免疫组化等实验室检查结果进行分析.结果:13例患者中有11例出现不同程度的肝脾肿大.外周血及骨髓涂片均可见数量不等的多毛淋巴细胞.免疫表型显示11例患者为经典的HCL,其淋巴细胞表达CD19、CD20、CD22、CD123、FMC7、CD103、CD25、CD11c;2例为变异型,不表达CD25和CD11c.骨髓活检11例患者骨髓增生活跃,毛细胞呈弥漫性分布,2例骨髓增生减低,毛细胞呈结节性分布.免疫组化显示CD19、CD20、CD25、CD103、CD11c为阳性,而CD23、CD38、CD5、CD10等均为阴性,与流式细胞学检测结果基本一致.结论:骨髓穿刺、白血病免疫分型、骨髓活检及免疫组化在HCL诊断中具有重要意义,且免疫分型能够更好地鉴别HCL与其他慢性淋巴细胞增殖性疾病.