|
Objective: To study the ratio and morphological characteristics of large granularlymphocytes in peripheral blood of normal human, and explore the significance of themorphological characteristics, the ratio, the absolute value of large granularlymphocyte and other hematological indicators with large granular lymphocyteleukemia in diagnosis and determining progression of this disease.Methods:100smears of normal adult peripheral blood and18cases finally diagnosedas large granular lymphocyte leukemia patients were assumed by microscope withstaning of Wright-Giemsa. Analyse and compaise the similarities and differences ofLGLs in morphology, proportions and absolute value and other relativelyhematological indicators.Results:1.The percentage of LGLs of normal person in peripheral blood changes in awider range, the (mean±standard deviation) of the percentage of LGLs in100whiteblood cells and100lymphocytes were11.29%±4.32%, and31.56%±9.24%respectively. The types of particles in LGLs’can be divided into3kinds: coarse, fineand dust, accounting for lymphocyte percentage was3.92%±2.84%,19.14%±6.78%and8.50%±5.23%respectively, and has no significant difference betweenmale and female and different age groups. Fine particles type and≥6accounte formost；2. Except1(6%) case of the18cases of LGLL showed atypical lymphocytesincreased, but no significant increase in granular lymphocyte (LGLs absolute value issignificantly higher), the mean±standard deviation of the percentage of LGLs andabsolute value were79%±15.98%and6.52±4.75×109/L, there is a significantdifference between normal and LGLL.(P＜0.01). Except2cases accepted therapy, theabsolute value of lymphocytes, in75%cases, was greater than5×109/L, and the absolute value of LGLs, in100%cases, was greater than2×109/L. Bonemarrow was active or hyperactive. The mean±standard deviations of the ratio oflymphoid cell series of32.58±15.86%, ranging from15%to68%,8cases (67%)within the normal range (10-30%), and there was no significant difference among thethree groups (P>0.05). The mean±standard deviation of the percentage of LGLs inBM was65.67±18.91%, with91%cases≥40%and73%cases≥50%，there was nosignificant difference among the three groups (P＞0.05). However, there was asignificant difference between the LGLs percentage in BP and BM3. statisticallydifferences were observed with age, WBC count, LC absolute value, LGL absolutevalue, hemoglobin, platelet count, absolute value of neutrophil between ANKL andCLPD-NK (all p＜0.05).).4.leukemic LGLs of LGLL patients also has3types, themorohologocal characteristics of LGLs in T-LGLL and CLPD-NK similar to thenormal’s, but cells in ANKL and CD56+T-LGLL displayed obvious heterogeneous,which more obviously in BM.Conclusion: Morphological characteristics of large granular lymphocyte should nolonger be confined to coarse large particles or particle number be limited to>3stars;Peripheral blood smears were more meaningful for diagnosing LGLL; BM bonemarrow smears is more advantageous to observe atypia leukemic cells, which arehelpful for the classification of disease and judging prognosis
|