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毛细胞白血病累及脑膜患者,男性,60岁,因额部疼痛进行性加剧1月余入院。检查:脾显著肿大,无神经系统异常的体征。外周血白细胞2,800,外周血及骨髓涂片见异常未成熟细胞增多,呈单个核,核染色质均匀而疏松,胞浆呈绒毛样突起,抗酒石酸性磷酸酶染色阳性。脑脊液蛋白83mg%,白细胞14/mm~3,其中13个是具有明显核仁的淋巴细胞,无特征性胞浆突起,抗酒石酸性磷酸酶染色阳性。治疗:行脾切除术,术后全颅照射(15次共3,000拉德),鞘内注射氨甲喋吟(5次共100mg);地塞米松逐渐减量。随访26个月,病情稳定〔Wolfe
Patients with hairy cell leukemia involving the meninges, male, 60 years of age, were admitted to hospital more than one month after their forehead pain was exacerbated. Check: Spleen significantly enlarged, no signs of nervous system abnormalities. Peripheral blood leukocytes 2,800, peripheral blood and bone marrow smear see abnormal immature cells increased, showing a single nucleus, nuclear chromatin uniform and loose, cytoplasmic villous protrusions, anti tartaric acid phosphatase staining. Cerebrospinal fluid protein 83mg%, white blood cells 14 / mm ~ 3, of which 13 are clearly nucleated lymphocytes, no characteristic cytoplasmic protrusions, anti-tartaric acid phosphatase staining. Treatment: splenectomy, postoperative total cranial irradiation (15 times a total of 3,000 rad), intrathecal injection of methotrexamycin (5 times a total of 100 mg); dexamethasone tapering. Follow-up 26 months, stable condition [Wolfe