從B-CLL轉變為T-PLL的罕見案例：流式細胞儀檢驗在臨床上的應用

A rare case of transformation from B-CLL to T-PLL: Clinical application of flow cytometry

此案病人原先在他院被診斷為B細胞淋巴球性白血病(B-cell chronic lymphocytic leukemia，B-CLL)，治療兩年後病人的白血球總數仍居高不下，經病理檢查顯示無原先的B細胞惡性腫瘤，然而卻觀察到疑似異常T細胞的表現。因此，本實驗室先以淋巴瘤篩檢管(Lymphoid Screening Tube，LST )執行流式細胞儀分析，發現T細胞表面標記表現異常，因此加做更完整的(T-cell chronic lymphoproliferative disorder, T-CLPD ) T細胞淋巴瘤螢光抗體套組，結果顯示已變為T細胞前淋巴球性白血病(T-PLL)，此篇文章將介紹本實驗室如何運用流式細胞儀檢驗，以協助醫師診斷。

The patient was originally diagnosed with B-cell chronic lymphocytic leukemia (B-CLL) at a different healthcare facility and underwent a pathological re-evaluation due to persistent leukocytosis despite two years of treatment. The report showed the absence of the original malignant cells, but indicated a suspicion of an abnormal cluster of T cells. Our laboratory conducted a flow cytometric analysis by using lymphoid screening tubes (LST) for flow cytometry analysis, we confirmed the abnormal T-cell population. This prompted us to perform a comprehensive T-cell chronic lymphoproliferative disorder (T-CLPD) panel. The results suggested a transformation into T-cell prolymphocytic leukemia (T-PLL). The aim of this article is to describe the use of flow cytometry analysis in our laboratory for the rapid diagnosis of such cases.