Thiele J, Titius B R, Kopsidis C, Fischer R
Institute of Pathology, University of Cologne.
Virchows Arch B Cell Pathol Incl Mol Pathol. 1992;62(5):275-82. doi: 10.1007/BF02899693.
A morphometric analysis of bone marrow trephine biopsies has been performed to study the frequency and planimetric characteristics of so-called atypical micromegakaryocytes in chronic myeloid leukemia (CML) and myelodysplastic syndromes (MDS). In addition, an attempt was made to discriminate this particular cell population from small immature elements of megakaryocytopoiesis, such as promegakaryoblasts and megakaryoblasts. The staining reactions employed included periodic acid-Schiff (PAS), alpha-naphthyl acetate esterase (ANAE) and immunohistochemistry with a monoclonal antibody against platelet glycoprotein IIIa (Y2/51-CD61). Comparison of the various staining reactions applied to the different megakaryocytic elements together with morphometric measurements resulted in a clearcut identification of promegakaryoblasts. These were defined as the earliest immature and exclusively CD61-positive precursors. Atypical micromegakaryocytes were characterized by their dysplastic features and strong ANAE reactivity in addition to their positive CD61 staining. When stringent diagnostic criteria (diameter ranging between 10 to 15 microns, mean size about 12 microns) were applied, this abnormal cell population comprised less than 10% of total megakaryocytopoiesis in CML and MDS. It may be assumed that dysmegakaryocytic features in the latter disorders are partially generated by small to medium-sized megakaryocytes (diameter less than 30 microns). In conclusion, the relative frequency of promegakaryoblasts in the normal bone marrow (range 6-8%) is confirmed by evaluation of the immunohistochemical and cytochemical staining methods (CD61 and ANAE). Furthermore, the ANAE reaction facilitates the recognition of atypical micromegakaryocytes as well as small megakaryocytes. Thus cytochemistry provides a better insight into alterations of these cell lineages in various pathological conditions.
已对骨髓环钻活检进行形态计量分析，以研究慢性髓性白血病（CML）和骨髓增生异常综合征（MDS）中所谓非典型微巨核细胞的频率和平面测量特征。此外，还尝试将这一特定细胞群与巨核细胞生成的小未成熟细胞成分（如原巨核细胞和巨核母细胞）区分开来。所采用的染色反应包括过碘酸-希夫（PAS）染色、α-萘乙酸酯酶（ANAE）染色以及使用抗血小板糖蛋白IIIa单克隆抗体（Y2/51-CD61）的免疫组织化学染色。将应用于不同巨核细胞成分的各种染色反应与形态计量测量结果进行比较，从而明确鉴定出原巨核细胞。这些细胞被定义为最早的未成熟且仅CD61阳性的前体细胞。非典型微巨核细胞的特征是除了CD61染色阳性外，还具有发育异常特征和强烈的ANAE反应性。当应用严格的诊断标准（直径在10至15微米之间，平均大小约12微米）时，在CML和MDS中，这一异常细胞群占巨核细胞生成总数的比例不到10%。可以推测，后两种疾病中的巨核细胞发育异常特征部分是由中小尺寸巨核细胞（直径小于30微米）产生的。总之，通过免疫组织化学和细胞化学染色方法（CD61和ANAE）评估，证实了正常骨髓中原巨核细胞的相对频率（范围为6 - 8%）。此外，ANAE反应有助于识别非典型微巨核细胞以及小巨核细胞。因此，细胞化学能够更好地洞察这些细胞谱系在各种病理状况下的变化。
