Muhury Manas, Mathai Alka M, Rai Sharada, Naik Ramadas, Pai Muktha R, Sinha Ruchi
Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.
Indian J Pathol Microbiol. 2009 Oct-Dec;52(4):490-4. doi: 10.4103/0377-4929.56132.
Dysplastic changes are well documented in myelodysplastic syndromes (MDS). However, they are also observed in non-MDS hematological conditions.
To evaluate the megakaryocytic alterations in the bone marrow aspirations in cases of non-MDS related thrombocytopenia.
A prospective study of 144 bone marrow aspirates was conducted in the department of pathology, Kasturba Medical College, Mangalore. The aspirates were studied to assess the number and morphology of the megakaryocytes in non-MDS related thrombocytopenia and evaluate their significance when compared to changes in MDS.
The bone marrow aspiration smears were stained with Leishman stain and examined under light microscope.
Fisher's exact test. A P value less than 0.05 was considered significant. Sensitivity and specificity was calculated for those features which were significant in the relevant hematological disorders.
The sensitivity of immature megakaryocytes, dysplastic forms and micromegakaryocytes in cases of immune thrombocytopenic purpura was 100%, 89% and 42% respectively. The specificity of emperipolesis was 74%. In cases of infection-associated thrombocytopenia, immature megakaryocytes had a sensitivity of 100% and cytoplasmic vacuolization were 86% specific. The sensitivity of the dysplastic forms in megaloblastic anemia was 75%. However, no platelet budding was observed. The presence of micromegakaryocyte had a specificity of 83% in MDS, and was statistically significant when compared to cases of non-MDS conditions (P 0.05).
Careful understanding of the morphological changes of megakaryocytes in bone marrow aspirates can improve the diagnostic accuracy for a wide range of hematological disorders thereby enabling proper therapeutic interventions.
骨髓发育异常综合征（MDS）中发育异常改变已有充分记录。然而，在非MDS血液系统疾病中也可观察到这些改变。
评估非MDS相关血小板减少症患者骨髓穿刺中巨核细胞的改变。
在芒格洛尔卡斯图尔巴医学院病理科对144例骨髓穿刺样本进行了一项前瞻性研究。对这些穿刺样本进行研究，以评估非MDS相关血小板减少症中巨核细胞的数量和形态，并与MDS中的变化进行比较以评估其意义。
骨髓穿刺涂片用利什曼染色，在光学显微镜下检查。
费舍尔精确检验。P值小于0.05被认为具有统计学意义。计算了在相关血液系统疾病中具有显著意义的特征的敏感性和特异性。
免疫性血小板减少性紫癜病例中未成熟巨核细胞、发育异常形态和微巨核细胞的敏感性分别为100%、89%和42%。血细胞吞噬的特异性为74%。在感染相关性血小板减少症病例中，未成熟巨核细胞的敏感性为100%，细胞质空泡化的特异性为86%。巨幼细胞贫血中发育异常形态的敏感性为75%。然而，未观察到血小板出芽。微巨核细胞的存在在MDS中的特异性为83%，与非MDS情况相比具有统计学意义（P<0.05）。
仔细了解骨髓穿刺中巨核细胞的形态变化可提高对多种血液系统疾病的诊断准确性，从而实现适当的治疗干预。
