Chronic lymphocytic leukemia (CLL) is a malignant tumor originating in hematopoietic tissue. The tumor cells are monoclonal B lymphocytes, which are similar to normal mature small lymphocytes and accumulate in blood, bone marrow and lymphoid tissues.
The cause of
Etiology has not been completely clear, environmental factors in the incidence of chronic lymphocytic leukemia does not occupy the main position, long-term exposure to low frequency electromagnetic field may be associated with the disease. The morbidity of Asian people in Asian countries and western countries is lower than that of European and American people. The risk of the disease is three times higher in the immediate family members of patients with chronic lymphocytic leukemia than the general population, and males are more prone to the disease than females, indicating that genetic factors play a certain role in the occurrence of the disease.
Clinical manifestations of
They are often asymptomatic in early stages and are often referred for painless lymphadenopathy or an increase in the absolute value of lymphocytes of unknown cause. Patients with mild fatigue, easy fatigue and other non-specific performance, once entered the progressive stage, in addition to the systemic lymph nodes and splenomegaly can be manifested as weight loss, repeated infection, bleeding and anemia symptoms. Due to the age of the susceptible population, patients often deteriorate due to chronic lung disease, cerebrovascular disease, cardiovascular disease and other potential chronic diseases.
1. Lymph node enlargement
80% of the patients had painless lymph node enlargement, which can be systemic, mild to moderate, occasionally obvious enlargement, non-adhesion with the skin, often involving the neck, clavicle, armpit and groin, etc.
2. The liver and spleen
Half of the patients had mild to moderate splenomegaly, accompanied by abdominal fullness, late pelvic cavity, spleen infarction or rupture, rare liver.
Anemia and bleeding
Anemia or thrombocytopenia may occur when the disease progresses, mostly due to leukocyte bone marrow infiltration or the generation of autoantibodies, occasionally due to splenomegaly caused by hypersplenism.
4. Extrinsic infiltration
Lymphocytes can infiltrate into the skin, conjunctiva, lung, pleura, gastrointestinal tract, bone, nervous system, kidney and so on.
Immune deficiency and immune disorder, such as conditional pathogenic pathogen infection, autoimmune diseases and secondary tumors.
1. The blood picture
The white blood cells were continuously increased 10 109/L, the proportion of lymphocytes 50%, and the absolute value of monoclonal lymphocytes 5 109/L. Anemia or thrombocytopenia may occur with tumor cell bone marrow invasion, post-treatment bone marrow suppression, immune destruction, or nutrient deficiency.
2. The bone marrow
Bone marrow hyperplasia was active, which was occupied by tumor cells, accounting for more than 40%. The morphology was basically the same as that of peripheral blood, and the formation of erythroid, granulocyte and megakaryocyte lines was inhibited. A bone marrow biopsy helps determine the extent of bone marrow involvement.
3. Lymph node biopsy
Lymph node pathology showed typical diffuse infiltration of small lymphocytes, which were consistent with lymphocytes in the blood.
About 50% of patients have chromosome number and structure abnormalities, mostly chromosome 12, 14 and 13 abnormalities.
5. Immunological examination
Flow cytometry was used to detect cell surface differentiation antigens, membrane surface immunoglobulin and, light chain to determine whether the cells proliferated clonically and provide further typing.