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杂合性急性白血病系既发生在淋巴细胞又发生在髓细胞水平的急性白血病。报道1例如下。患者男性,17岁,农民,因头晕、乏力、鼻衄1月余,于1990年2月15日入院。体检:贫血貌,皮肤粘膜无出血点及瘀斑,颌下可触及蚕豆大小淋巴结两颗,心肺听诊正常,肝肋下1.5cm,质软无压痛,脾肋下2cm,实验室检查:Hb67g/L,WBC21.3×10~9/L,原始细胞0.86,分叶核0.01,淋巴细胞0.01,血小板数72×10~9/L,骨髓有核细胞增生明显活跃,原始细胞占0.94,大小不等,胞浆少,呈淡蓝色,部分有伪足突起及空泡,核大,染色质疏松,部分核可见切凹,有1～3个核仁。白血病细胞组化:POX(-),NAE弱阳性,可被NaF抑制,PAS(+),细胞大多数呈细颗粒状,少数呈粗粒状;细胞表型:CD_10,CD_20.21,OKT_30.29,OKT_40.27,OKT_80.13,CD_90.13,CD_(10)0.61,CD_(19)
Heterozygous acute leukemia occurs both in lymphocytes and in myeloid leukemia. 1 case reported below. Male patient, 17 years old, farmer, due to dizziness, fatigue, epistaxis more than 1 month, was admitted on February 15, 1990. Physical examination: Anemia, skin and mucous membrane without hemorrhage and ecchymosis, submaxillary reach broad bean size lymph nodes, cardiopulmonary auscultation normal, liver ribs 1.5cm, soft without tenderness, spleen ribs 2cm, laboratory tests: Hb67g / L, WBC21.3 × 10 ~ 9 / L, primitive cells 0.86, lobulated 0.01, lymphocytes 0.01, platelet count 72 × 10 ~ 9 / L, significantly increased bone marrow nucleated cells, primitive cells accounted for 0.94, the size is not And so on, less cytoplasm, pale blue, with pseudopod protuberances and vacuoles, large nuclei, chromatin loose, partial nuclear see concave, with 1 to 3 nucleoli. The leukemic cells were weakly positive for POX (-) and NAE, which could be inhibited by NaF. Most of PAS (+) cells were finely granular with a few of them being coarse granular. The cell phenotypes were CD_10, CD_20.21 and OKT_30.29 , OKT_40.27, OKT_80.13, CD_90.13, CD_ (10) 0.61, CD_ (19)