OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press68210.17650/1818-8346-2007-0-3-65-69RARE AND DIFFICULT HEMATOLOGIC SYNDROMESРЕДКИЕ И СЛОЖНЫЕ ГЕМАТОЛОГИЧЕСКИЕ СИНДРОМЫMyeloid/natural killer cell precursor acute leukaemia. Case report and literature reviewОстрый лейкоз из миелоидных/NK-клеток-предшественников. Описание случая и обзор литературыGorodetskyV. R.ГородецкийВ. Р.
Russian Federation

Moscow 

Москва

ProbatovaN. A.ПробатоваН. А.
Russian Federation

Moscow 

Москва

TupitsynN. N.ТупицынН. Н.
Russian Federation

Moscow 

Москва

KovriginaA. M.КовригинаА. М.
Russian Federation

Moscow 

Москва

SholokhovaE. N.ШолоховаЕ. Н.
Russian Federation

Moscow 

Москва

FrenkelM. A.ФренкельМ. А.
Russian Federation

Moscow 

Москва

KondratyevaT. T.КондратьеваТ. Т.
Russian Federation

Moscow 

Москва

GrivtsovaL. Yu.ГривцоваЛ. Ю.
Russian Federation

Moscow 

Москва

FleishmanE. V.ФлейшманЕ. В.
Russian Federation

Moscow 

Москва

PavlovskayaA. I.ПавловскаяА. И.
Russian Federation

Moscow 

Москва

N.N. Blokhin Cancer Research CenterРОНЦ им.Н.Н.Блохина РАМНCentral Clinical Hospital №2, Ministry of Railway communicationsЦентральная клиническая больница №2 МПС230820073656923112022231120222007https://oncohematology.abvpress.ru/ongm/article/view/682

We describe a rare case of myeloid/NK cell precursor acute leukemia (MNKL) in a 38-year-old woman. Upon diagnostic examination, a tumor invasion of bone marrow, lymphatic nodes, liver and spleen was found. The proportion of blasts in peripheral blood reached 54%. The blasts were polymorphic, with round or irregularly shaped nuclei. The tumor cells were negative for myeloperoxidase, non-specific esterase, and lipid staining. The blasts not only expressed CD13+ and CD33+ panmyeloid antigens, but also carried the markers of NK-cell differentiation (CD16+, CD56+, Perforin+). The leukemoid infiltration of liver, acute hepatitis and development of liver cell failure were the distinctive features of the described case. The issues pertaining to differential diagnostics and classification of MNKL are also discussed.

В статье описан редкий случай острого лейкоза из миелоидных/NK-клеток-предшественников (MNKL) у женщины 38 лет. У больной наблюдалось опухолевое поражение костного мозга, лимфатических узлов, печени и селезенки. Число бластов в периферической крови достигало 54%. Бласты отличались цитологическим полиморфизмом. Встречались клетки как с округлой, так и с неправильной формой ядра. Опухолевые клетки были негативны при окрашивании на миелопероксидазу, липиды, неспецифическую эстеразу. Бласты экспрессировали панмиелоидные маркеры (CD13+, CD33+) и имели иммунологические признаки NK-клеточной дифференцировки (CD16+, CD56+, Perforin+). Клинической особенностью нашего случая было лейкемоидное поражение печени, сопровождающееся клиникой острого гепатита с развитием печеночно-клеточной недостаточности. В статье также обсуждаются вопросы дифференциальной диагностики и классификации MNKL.

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