Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Hum Pathol. 2012 Feb;43(2):153-64. doi: 10.1016/j.humpath.2011.08.008. Epub 2011 Dec 9.
Prominent erythroid proliferations (in which erythroid elements comprise ≥50% of total bone marrow cells) can be seen in various hematopoietic stem cell neoplasms. The myeloproliferative neoplasm polycythemia vera exhibits effective, overexuberant erythropoiesis resulting in an increased red blood cell mass; in contrast, most other diseases characterized by erythroid predominance exhibit ineffective hemopoiesis. The latter include acute erythroid leukemia (erythroid-myeloid and pure erythroid leukemia subtypes) as well as some cases of myelodysplastic syndromes, acute myeloid leukemia with myelodysplasia-related changes, and therapy-related myeloid neoplasms. Some nonneoplastic reactive conditions may also manifest a striking bone marrow erythroid predominance. In this article, we review the literature relevant to this group of diseases for a better understanding of their clinicopathologic features and surrounding controversies. We also examine the position of neoplastic erythroid proliferations in the current 2008 World Health Organization Classification of Myeloid Neoplasms and provide recommendations as to how to approach the differential diagnosis of this group of diseases.
各种造血干细胞肿瘤中可见明显的红系增生（其中红系细胞占骨髓细胞总数的≥50%）。骨髓增殖性肿瘤真性红细胞增多症表现为有效的、过度旺盛的红细胞生成，导致红细胞数量增加；相比之下，大多数以红系增生为主的其他疾病表现为无效造血。后者包括急性红细胞白血病（红系-髓系和纯红细胞白血病亚型）以及一些骨髓增生异常综合征、伴骨髓增生异常相关改变的急性髓系白血病和治疗相关髓系肿瘤。一些非肿瘤性反应性疾病也可能表现出明显的骨髓红系增生。本文回顾了与这组疾病相关的文献，以更好地了解其临床病理特征和相关争议。我们还检查了在当前 2008 年世界卫生组织髓系肿瘤分类中肿瘤性红细胞增生的位置，并就如何处理该组疾病的鉴别诊断提出建议。
