Macavei I, Galatâr N
Department of Haematology, Oncological Institute, Cluj-Napoca, Romania.
Morphol Embryol (Bucur). 1990 Jan-Mar;36(1):25-32.
Bone marrow biopsies have been investigated in 330 cases of Hodgkin's disease totalising 298 patients, out of which 32 with repeated biopsies. Positive biopsies with typical lesions were found in 32% of patients, the majority in stages III and IV (88.6%), rarely in stage I or II (11.4%). Nonspecific lesions were very frequent (75%), either isolated or accompanied by typical lesions. The majority of the positive biopsies were found in patients with lymphocytic predominance and lymphocytic depletion, or in polytreated patients in an advanced stage of the disease. The specific marrow involvement consisted in lymphocytic infiltrations either nodular or diffuse, Reed-Sternberg (R-St) or Hodgkin cells. The lymphocytic depletion is often accompanied by diffuse fibrosis, atypical histiocytes, fibroblasts and R-St cells. Hodgkin typical granulomas are rare. The positive biopsies were associated with nonspecific reactions including hyperplasia of granulopoiesis, megakaryocytes, territories with hyperplasia or aplasia, fibrosis, disruption of sinus walls, oedema, plasmocytosis, necrosis, myelomonoblastic cells, lymphocyte nodes, etc. The bone marrow histology has a prognostic significance.
对298例霍奇金病患者的330份骨髓活检样本进行了研究,其中32例进行了重复活检。32%的患者活检结果呈阳性且有典型病变,大部分处于III期和IV期(88.6%),I期或II期患者少见(11.4%)。非特异性病变非常常见(75%),可为孤立性或伴有典型病变。大部分阳性活检结果见于淋巴细胞为主型和淋巴细胞消减型患者,或疾病晚期接受过多种治疗的患者。骨髓特异性受累表现为结节状或弥漫性淋巴细胞浸润、里德-斯腾伯格(R-S)细胞或霍奇金细胞。淋巴细胞消减常伴有弥漫性纤维化、非典型组织细胞、成纤维细胞和R-S细胞。霍奇金典型肉芽肿少见。阳性活检结果常伴有非特异性反应,包括粒细胞生成、巨核细胞增生、增生或发育不全区域、纤维化、窦壁破坏、水肿、浆细胞增多、坏死、骨髓单核母细胞、淋巴细胞结节等。骨髓组织学具有预后意义。