Department of Geriatric Medicine, Tokyo Medical University, Tokyo 160-0023, Japan.
Geriatr Gerontol Int. 2009 Dec;9(4):395-8. doi: 10.1111/j.1447-0594.2009.00556.x.
Myelofibrosis is often observed in chronic myeloproliferative disorders (CMPD), but non-Hodgkin's lymphoma with diffuse myelofibrosis is rare. We describe an elderly case with peripheral T-cell lymphoma-unspecified (PTCL) presenting as diffuse myelofibrosis. Bone marrow biopsy revealed infiltration of atypical lymphocytes and diffuse myelofibrosis without any increase in megakaryocytes. To discuss the pathogenesis of fibrosis, we examined cytokines relative to fibrosis using immunostaining. The expression of basic fibroblast growth factor (bFGF) was diffusely detected in the area of extracellular matrix of bone marrow. In addition, in situ hybridization revealed that infiltrating lymphoma cells expressed bFGF mRNA. Basic FGF, originally identified based on its mitogenicity for fibroblasts, has multiple potential, influencing neoangiogenesis, bone marrow fibrosis and the proliferation of tumor cells. Basic FGF might play an important role in the pathogenesis of myelofibrosis in the present case.
骨髓纤维化常发生于慢性骨髓增殖性疾病(CMPD)中,但弥漫性骨髓纤维化的非霍奇金淋巴瘤较为罕见。我们描述了一例老年外周 T 细胞淋巴瘤未分类(PTCL)患者,表现为弥漫性骨髓纤维化。骨髓活检显示有异型淋巴细胞浸润和弥漫性骨髓纤维化,巨核细胞无增多。为探讨纤维化的发病机制,我们使用免疫组化检测了与纤维化相关的细胞因子。碱性成纤维细胞生长因子(bFGF)在骨髓细胞外基质区弥漫表达。此外,原位杂交显示浸润的淋巴瘤细胞表达 bFGF mRNA。碱性成纤维细胞生长因子最初是根据其对成纤维细胞的有丝分裂活性而被鉴定的,它具有多种潜在功能,影响新血管生成、骨髓纤维化和肿瘤细胞的增殖。碱性成纤维细胞生长因子可能在本病例骨髓纤维化的发病机制中起重要作用。