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患者,女,18岁。因发现颈部肿块半年余于2005年9月26日入院入院前1个月在其他医院行颈部右侧肿块活检,免疫组化示 CD99(+)、MPO(+)、CD68(+),其余淋系相关抗原表达均阴性,诊断为(颈部)粒细胞肉瘤。患者入院时无发热、乏力等症状。查体:体温36.9℃,颈部双侧及下颌骨上下可及多枚肿大淋巴结,无粘连,活动度可,除下颌骨左侧肿块有轻度触痛外,余无触痛。血常规:WBC 7.8×10~9/L,中性粒细胞0.373,淋巴细胞0.596,Hb 108g/L,BPC 417×10~9/L。骨髓象:原始淋巴细胞+幼稚淋巴细胞占0.640,组化示 POX(-),SB(-),NSE(-),NAF 不显色。免疫分型:CD117(+),MPO(-),CD46(+),CD34和 HLA-DR 均阳性,原始细胞群同时伴 CD19和 CD7的表达诊断:急性非淋巴细胞白血病(M_0)。入院后以 DA+VP 方案(柔红霉素60 mg 第1～3天;阿糖胞苷150 mg 第1～7人;长春新碱
Patient, female, 18 years old. The results of immunohistochemistry showed that CD99 (+), MPO (+), CD68 (+) and CD68 (+) were detected in the right neck of other hospitals at one month before hospitalization on September 26, The remaining lymphoid-associated antigen expression was negative, diagnosed as (neck) granulocytic sarcoma. Patients admitted to hospital without fever, fatigue and other symptoms. Physical examination: body temperature 36.9 ℃, bilateral neck and mandible up and down and can be multiple enlarged lymph nodes, no adhesions, activity can be, except for the left mandibular mass with mild tenderness, I no tenderness. Blood routine: WBC 7.8 × 10 ~ 9 / L, neutrophil 0.373, lymphocyte 0.596, Hb 108g / L, BPC 417 × 10 ~ 9 / L. Bone marrow: primitive lymphocytes + naive lymphocytes accounted for 0.640, group showed POX (-), SB (-), NSE (-), NAF no color. Immunophenotyping: The positive expression of CD117 (+), MPO (-), CD46 (+), CD34 and HLA-DR was detected in primary cell population with both CD19 and CD7: acute non-lymphocytic leukemia (M_0). Admission to the DA + VP program (daunorubicin 60 mg first days to three days; cytarabine 150 mg first to seven people; vincristine