Institute of Pathology of the Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.
Pathol Res Pract. 2012 Sep 15;208(9):510-7. doi: 10.1016/j.prp.2012.05.008. Epub 2012 Jul 15.
Bone marrow biopsy of the iliac crest is the first and most important step in the diagnostics of hematopoietic disorders. The biopsies of the years 2006 and 2007 from the Institute of Pathology of the Jena University Hospital were retrospectively analyzed for clinicopathological parameters. In addition, the Mitelman database was retrieved for chromosomal aberrations. The analysis of 2820 reports from 1185 patients revealed that lymphomas, plasma cell myeloma and acute leukemia were most frequent. Males predominated in myeloproliferative neoplasms and lymphoma subtypes, particularly CLL, except for plasma cell myeloma and acute leukemia. A peak incidence was seen between 61 and 70 years of age with a varying pattern for single entities. The database search revealed that ALL, AML, CLL and CML were mainly diploid while Hodgkin lymphoma, mature B-cell lymphoma and multiple myeloma mostly carried hyperdiploid chromosome numbers. Numerical aberrations like chromosome 8 gains in hyperdiploid CML were prominent in specific subgroups. Molecular testing is exemplified in CML, plasma cell myeloma and hairy cell leukemia. The study highlights typical clinicopathological characteristics and new genetic findings in hematopoietic and lymphoid neoplasms with relevance for the new WHO classification and beyond. We hope that it may help in the differential diagnosis of bone marrow biopsies.
髂嵴骨髓活检是造血系统疾病诊断的第一步，也是最重要的一步。对耶拿大学医院病理学研究所 2006 年和 2007 年的活检进行了回顾性分析，以评估临床病理参数。此外，还从米特尔曼数据库中检索了染色体异常。对 1185 例患者的 2820 份报告进行分析后发现，淋巴瘤、浆细胞瘤和急性白血病最为常见。在骨髓增殖性肿瘤和淋巴瘤亚型中，男性占主导地位，除浆细胞瘤和急性白血病外，CLL 也是如此。61 至 70 岁之间的发病率最高，各单一实体的模式各不相同。数据库检索显示，ALL、AML、CLL 和 CML 主要为二倍体，而霍奇金淋巴瘤、成熟 B 细胞淋巴瘤和多发性骨髓瘤主要携带超二倍体染色体数目。在特定亚组中，超二倍体 CML 中 8 号染色体的获得等数值异常较为突出。分子检测在 CML、浆细胞瘤和毛细胞白血病中得到了例证。该研究强调了造血和淋巴系统肿瘤的典型临床病理特征和新的遗传学发现，这些发现与新的 WHO 分类及其它相关。我们希望它可以帮助进行骨髓活检的鉴别诊断。
