Kikuchi M, Ohshima K, Kobari S
1st Department of Pathology, School of Medicine, Fukuoka University.
Rinsho Byori. 1991 Dec;39(12):1245-9.
Histopathologic diagnosis of the bone marrow in leukemia is usually a supplementary method to the cytological in acute and chronic leukemia. However, for patients with MDS and MPD and with dry tap bone marrow biopsy is very important. Important morphological findings and useful immunohistochemical methods for differentiation and characterization of leukemia are reported and the usefulness of sequential examination of bone marrow in leukemia during and after chemotherapy is emphasized. In addition to leukemia, histological features and differential points of myelodysplastic syndrome (MDS) and myeloproliferative disorders (MPD) are mentioned. The proliferating megakaryocytes differed in size and shape between MDS and MPD. The difference in proliferating rate of the cells examined by PCNA was also useful to differentiate the two disorders histologically.
白血病骨髓的组织病理学诊断通常是急性和慢性白血病细胞学诊断的补充方法。然而,对于骨髓增生异常综合征(MDS)和骨髓增殖性疾病(MPD)患者以及骨髓干抽患者,骨髓活检非常重要。报告了白血病鉴别和特征化的重要形态学发现及有用的免疫组织化学方法,并强调了化疗期间及化疗后白血病患者骨髓序贯检查的实用性。除白血病外,还提及了骨髓增生异常综合征(MDS)和骨髓增殖性疾病(MPD)的组织学特征及鉴别要点。MDS和MPD中增殖的巨核细胞在大小和形态上有所不同。通过增殖细胞核抗原(PCNA)检测的细胞增殖率差异在组织学上也有助于区分这两种疾病。