急性白血病病例報告

AcuteLeukemia

097805鄭志博Case:Amalepatient,40Yearsold,hasassociatedwithbleedingtendencyfor10days.Hecametoourdepartmentfordiagnosis.Case:Hehadfeverwithoutobviouscause10daysago,38.2℃,bodyaches,mildcough,alittlewhitesputum,alsofoundgumsbleedingwhenbrushingteeth,hadabnormalbloodtestatlocalclinic(unclear).Anti-coldmedicinewithouteffort,poorsleep,urineandstoolarenormal,noobviouschangeinbodyweightHistoryrecordHealth,nohistoryoftuberculosis(TB),nohistoryofdrugallergy.Notaddictedtoalcohol,tobacco,nosimilarfamilymedicalhistoryPhysicalexamnationT38.2℃，HR98per/min，RR20

per/min，BP120/80mmHgShowedacutehotillface,chestandlowerlimbskinhadscatteredbleeder,superficiallymphnodeuntouched,sclerawithoutstainedyellow,pharyngealhyperemia(+),tonsils(-).Sternalpresspain,lungpercussionnaormal,rightlunglowerlobehadmoistrales,abdomenflatsoft,liverandspleenuntouchedundertherib,lowerlimbsarenotswollenLaboratorytestsHb95g/L，Ret0.5%，WBC3.8×109/L，Blasts48%，PLT30×109/L；urine(-),stool(-)Question(1)ThiscasewhatisthemostlikelydiagnosisDiagnosisisbasedonwhat

(2)Describethediseaseswithwhichcasesshouldbeidentified(3)Whatothertestsshouldbeused(4)Describethetreatmentofthiscase.Answers(1)diagnosis:Acuteleukemia.Diagnosisisbasedon:fever,anemia,，Blasts48%>20%，PLT30×109/L

<60×109/L(2)ThiscaseneedtoidentifiedwithMDS,AA,ITP,IM,leukemoidreaction.(3)cytochemistryImmunologicaltest,chromosomeexamination

急淋急粒急單過氧化物酶（POX）（—）分化差的原始細胞（—）～（＋）

分化好的原始細胞（＋）～（＋＋＋）（—）～（＋）糖原反應（PAS）（＋）成塊或顆粒狀彌漫性淡紅色（—）/（＋）顆粒細而散在（—）/（＋）非特異性酯酶（NSE）（—）NaF抑制不敏感（—）/（＋）能被NaF抑制（—）/（＋）堿性磷酸酶（ALP/NAP）增加減少或（—）正?；蛟黾?/p>

(4)Thiscasetreatmentmeasuresinclude:generaltreatment

Chemicaltherapy:ALL:DVtherapy,AML:DA,HA,HOAPtherapyBonemarrowtransplantationSupportivetherapy:Preventinfection,correctionanemia,controlhemorrhageandmaintainnutrition.Thankyouforlistening.1、字體安裝與設置如果您對PPT模板中的字體風格不滿意，可進行批量替換，一次性更改各頁面字體。在“開始”選項卡中，點擊“替換”按鈕右側箭頭，選擇“替換字體”。（如下圖）在圖“替換”下拉列表中選擇要更改字體。（如下圖）在“替換為”下拉列表中選擇替換字體。點擊“替換”按鈕，完成。132、替換模板中的圖片模板中的圖片展示頁面，您可以根據(jù)需要替換這些圖片，下面介紹兩種替換方法。方法一：更改圖片選中