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[不同血液系统疾病中胸骨与髂骨骨髓的组织学差异]

[Histological differences between sternal and iliac bone marrow in various hematological diseases].

作者信息

Nagasaka T, Nakashima N, Takeuchi J

机构信息

Division of Pathology, Nagoya University Hospital.

出版信息

Rinsho Byori. 1991 Jun;39(6):656-60.

PMID:1880943
Abstract

Even in normal state, hematopoietic activity is different in terms of the site of bone marrow as well as age. The activity may also differ with bone marrow site in various hematological diseases. We chose 32 cases with various hematological diseases and examined their bone marrow histologically at two different sites (sternum and posterior iliac crest) at almost the same time. We studied the histological differences in 5 cases of malignant lymphoma, 15 cases of aplastic anemia, 8 cases of myelodysplastic syndrome, 2 cases of myeloproliferative syndrome and 2 cases of acute leukemia. In malignant lymphoma, the iliac marrow was slightly hypoplastic compared with sternal marrow but there were no differences in the components of hematopoietic cells, that were thought to reflect normal hematopoietic activity for their respective ages. In 5 among 15 cases of aplastic anemia, nodular hyperplastic areas were observed in sternal marrow even though iliac marrow was severely hypoplastic. The presence of a nodular hyperplastic area is useful for differential diagnosis between aplastic anemia and refractory anemia, because such a histological change was not observed in the cases of refractory anemia. In myeloproliferative syndrome and acute leukemia, there were no differences between sternal and iliac marrow. They were hyperplastic and had almost the same hematopoietic components.

摘要

即使在正常状态下,造血活动在骨髓部位以及年龄方面也存在差异。在各种血液系统疾病中,造血活动也可能因骨髓部位不同而有所差异。我们选取了32例患有各种血液系统疾病的患者,并几乎在同一时间对其胸骨和后髂嵴这两个不同部位进行了骨髓组织学检查。我们研究了5例恶性淋巴瘤、15例再生障碍性贫血、8例骨髓增生异常综合征、2例骨髓增殖性综合征和2例急性白血病的组织学差异。在恶性淋巴瘤中,与胸骨骨髓相比,髂骨骨髓略显发育不全,但造血细胞成分并无差异,这些差异被认为反映了各自年龄阶段的正常造血活动。在15例再生障碍性贫血患者中,有5例胸骨骨髓出现结节性增生区域,尽管髂骨骨髓严重发育不全。结节性增生区域的存在有助于再生障碍性贫血与难治性贫血的鉴别诊断,因为在难治性贫血病例中未观察到这种组织学变化。在骨髓增殖性综合征和急性白血病中,胸骨骨髓和髂骨骨髓之间没有差异。它们均增生,且造血成分几乎相同。

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