摘要
目的分析小细胞肺癌骨髓转移的骨髓细胞形态学和临床特征,提高对该疾病的诊断。方法选择5例小细胞肺癌骨髓转移患者,对其临床特征及骨髓细胞形态学进行回顾性分析。结果5例小细胞肺癌骨髓转移患者均为中老年,临床上以淋巴结肿大、咳嗽、贫血伴血小板减少最为常见。血液学检查发现ɑ-羟丁酸脱氢酶(HBDH)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、碱性磷酸酶(ALP)升高明显,红细胞计数(RBC)下降、网织红细胞计数(RET)正常,网织红细胞百分比(RET%)正常或升高。骨髓细胞学检查发现小细胞肺癌骨髓转移癌细胞在骨髓涂片中以散在和/或小团分布为主,与原幼淋巴细胞相似,部分癌细胞核及胞质可见淡蓝色云雾状球形、真菌孢子样、鹰眼样包涵体。结论诊断小细胞肺癌骨髓转移要结合病史-体征-实验室检查-骨髓细胞形态学综合分析。掌握小细胞肺癌骨髓转移肿瘤细胞在骨髓涂片上的形态学特点及临床特征对早期诊断小细胞肺癌骨髓转移具有提示作用。
Objective To analyze the bone marrow cell morphology and clinical characteristics of small cell lung cancer with bone marrow metastasis,in order to improve the diagnosis of this disease.Methods 5 patients with small cell lung cancer and bone marrow metastasis were selected for retrospective analysis of their clinical characteristics and bone marrow cell morphology.Results All 5 patients with small cell lung cancer and bone marrow metastasis were middle-aged or elderly.Clinically,the most common manifestations were enlarged lymph nodes,cough,anemia with thrombocytopenia.Hematological examinations revealed significant increases inα-hydroxybutyrate dehydrogenase(HBDH),lactate dehydrogenase(LDH),creatine kinase(CK),and alkaline phosphatase(ALP),while the red blood cell count(RBC)decreased and the reticulocyte count(RET)was normal.The reticulocyte percentage(RET%)was normal or increased.Bone marrow cytology examinations showed that the metastatic small cell lung cancer cells in the bone marrow smears were mainly scattered or distributed in small clusters,resembling the appearance of primitive lymphocytes.Some cancer cells had light blue,misty,spherical inclusions in the nucleus and cytoplasm,resembling fungal spores or eagle eyes.Conclusion The diagnosis of bone marrow metastasis in small cell lung cancer requires a comprehensive analysis combining medical history,physical signs,laboratory tests,and bone marrow cytology.Mastering the morphological characteristics of metastatic small cell lung cancer cells in bone marrow smears and their clinical features can provide valuable clues for the early diagnosis of bone marrow metastasis in small cell lung cancer.
出处
《实用癌症杂志》
2025年第5期808-811,共4页
The Practical Journal of Cancer
关键词
小细胞肺癌
骨髓转移
骨髓细胞形态学
Small Cell Lung Cancer
Bone Marrow Metastasis
Bone Marrow Cytomorphology
