Yotsumoto Mihoko, Ishida Fumihiro, Ito Toshiro, Ueno Mayumi, Kitano Kiyoshi, Kiyosawa Kendo
Second Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621.
Intern Med. 2003 Jun;42(6):525-8. doi: 10.2169/internalmedicine.42.525.
A 55-year-old woman presented with massive refractory ascites in the course of idiopathic myelofibrosis. The ascites was exudative, and a cytological examination revealed granulocytes of varying maturity, erythroblasts, and megakaryocytes with trisomy 8. The ascites was assumed to have developed from peritoneal extramedullary hematopoiesis. An abnormal karyotype in the cells in the ascitic fluid, which was the same abnormality as in peripheral blood, helped to prove extramedulary hematopoiesis in this case, which can be an aid in making a differential diagnosis in cases of ascites associated with myelofibrosis.
一名55岁女性在特发性骨髓纤维化病程中出现大量难治性腹水。腹水为渗出液，细胞学检查发现有不同成熟度的粒细胞、成红细胞和8号染色体三体的巨核细胞。腹水被认为是由腹膜外髓造血发展而来。腹水中细胞的异常核型与外周血中的异常核型相同，这有助于证实本例中的髓外造血，在诊断与骨髓纤维化相关的腹水病例时可辅助进行鉴别诊断。
