Keywords: lymphatic leukemia diagnostic criteria
(A), medical history and symptoms
⑴ history questions: slow onset, patients without obvious symptoms, the interrogation should be noted that if there is fever, night sweats, and susceptible to performance.
(2) clinical symptoms: fatigue, weight loss, anorexia, night sweats, physical loss, fever, occasional itchy skin.
(B), the examination found
Lymphadenopathy hard, medium quality, removable late adhesions between fusion; mild swelling of the liver and spleen, late spleen was enlarged. Bone pain is not obvious. Advanced skin visible bleeding.
(C) laboratory examinations
Blood: positive cells are pigmented anemia. The white blood cell count> 10 × 109 / L, Category: lymphocytes> 50%, the absolute value of> 5.0 × 109 / L; mature lymphocytes, immature lymphocytes and atypical lymphocytes. Platelet normal or reduced.
Bone marrow: hyperplasia active to extremely active, mature lymphocyte proliferation significantly, accounting for more than 40% the original naive lymphocytes <10%. Erythroid, myeloid relatively reduced, normal or decreased megakaryocytes.
. Serum immunoglobulin reduced; monoclonal immunoglobulin increased, mostly for the IgM type. positive test of the kappa light chain or lambda light chain.
(D), the clinical stage of CLL and differential diagnosis
1. Installments: Phase I: lymphocytosis, and may be accompanied by swollen lymph nodes.
Phase Ⅱ: Ⅰ + hepatomegaly or splenomegaly.
Ⅲ: Ⅰ period or phase Ⅱ + anemia (hemoglobin <100g / L) or / and thrombocytopenia (<100 × 109 / L).
2 The differential diagnosis of tuberculous lymphadenitis, lymphoma, the infectious mononucleosis histiocytosis, hairy cell leukemia, prolymphocytic leukemia and other identification.