Rosenthal N S, Farhi D C
Institute of Pathology, Case Western Reserve University, Cleveland, Ohio 44106.
Am J Clin Pathol. 1991 Apr;95(4):556-60. doi: 10.1093/ajcp/95.4.556.
Acute myeloid leukemia (AML) is characterized by trilineage dysplasia, including atypical megakaryocytes. Acute megakaryoblastic leukemia (FAB M7) is particularly associated with atypical megakaryocytic hyperplasia (AMH). Fifteen patients with nonmegakaryoblastic AML developed AMH after therapy, comprising 12.6% of cases of AML diagnosed from 1986 to 1989. Platelet counts were normal in nine patients and decreased in six. Blasts comprised less than 5% of cells in 40% of the biopsies, ranged from 5-15% in 53%, and comprised more than 30% of cells in 7%. Numerous small hypo- and hyperlobated megakaryocytes were seen in all specimens, often occurring in clusters, and were more easily seen in sections than in smears. Subsequent biopsies in 13 patients showed a remission marrow in seven, increased blasts in three, and AML in three; none showed AMH. AMH resembling acute megakaryoblastic leukemia may be seen transiently after treatment of AML.
急性髓系白血病（AML）的特征是三系发育异常，包括非典型巨核细胞。急性巨核细胞白血病（FAB M7）尤其与非典型巨核细胞增生（AMH）相关。15例非巨核细胞白血病患者在治疗后出现AMH，占1986年至1989年诊断的AML病例的12.6%。9例患者血小板计数正常，6例降低。40%的活检标本中原始细胞占细胞总数不到5%，53%的标本中原始细胞占5%-15%，7%的标本中原始细胞占细胞总数超过30%。在所有标本中均可见大量小的分叶过少和过多的巨核细胞，常成簇出现，在切片中比涂片更容易看到。13例患者随后的活检显示，7例骨髓缓解，3例原始细胞增多，3例为AML；均未显示AMH。AML治疗后可能会短暂出现类似急性巨核细胞白血病的AMH。
