Rastogi Pulkit, Naseem Shano, Varma Neelam, Das Reena, Ahluwalia Jasmina, Sachdeva Man Updesh Singh, Sharma Prashant, Kumar Narender, Marwaha Ram Kumar
Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Hematol Blood Transfus. 2015 Mar;31(1):57-60. doi: 10.1007/s12288-014-0405-1. Epub 2014 May 23.
Bone marrow involvement in neuroblastoma indicates advanced stage of disease. The recent use of autologous bone marrow "rescue", has provided an additional important reason for accurate assessment of bone marrow status in newly diagnosed patients. In this study, we analyzed 44 cases of neuroblastoma for bone marrow infiltration status and their hematological parameters. Eighty-eight bone marrow aspirate and trephine touch imprint smears and 44 trephine biopsy sections were examined in these 44 patients. Of these, 24 cases (54.5 %) showed marrow infiltration. Leucopenia and bicytopenia were significantly (p < 0.05) associated with marrow infiltration. Both bone marrow aspirate and biopsy were positive for infiltration in 16 out of 24 positive cases. Only aspirate smears were positive in 4 and only trephine biopsy in another 4 cases. The pattern of infiltration consisted of rosette formation in 40.7 % cases on aspirate smears and 22.2 % cases in trephine biopsies. Remaining cases showed diffuse and interstitial presence of tumor cells and cases positive only on trephine biopsy, showed marked stromal reaction. Bilateral trephine biopsies combined with aspirate smears picked up all positive cases compared to when they were assessed alone.
骨髓受累在神经母细胞瘤中提示疾病处于晚期。近期自体骨髓“挽救”的应用，为准确评估新诊断患者的骨髓状态提供了另一个重要原因。在本研究中，我们分析了44例神经母细胞瘤患者的骨髓浸润状态及其血液学参数。对这44例患者的88份骨髓穿刺涂片和环钻触片涂片以及44份环钻活检切片进行了检查。其中，24例（54.5%）显示骨髓浸润。白细胞减少和双细胞减少与骨髓浸润显著相关（p<0.05）。在24例阳性病例中，16例骨髓穿刺和活检均为浸润阳性。仅穿刺涂片阳性的有4例，仅环钻活检阳性的有另外4例。浸润模式包括穿刺涂片上40.7%的病例呈玫瑰花结形成，环钻活检中22.2%的病例呈玫瑰花结形成。其余病例显示肿瘤细胞弥漫性和间质性存在，仅环钻活检阳性的病例显示明显的间质反应。与单独评估时相比，双侧环钻活检联合穿刺涂片检出了所有阳性病例。
