骨髓坏死：对骨髓活检标本的十年回顾性研究
Bone marrow necrosis: ten-year retrospective review of bone marrow biopsy specimens.
作者信息
Wool Geoffrey D, Deucher Anne
机构信息
From the Department of Pathology, University of Chicago, Chicago, IL; and Department of Laboratory Medicine, University of California, San Francisco.
Department of Laboratory Medicine, University of California, San Francisco.
出版信息
Am J Clin Pathol. 2015 Feb;143(2):201-13; quiz 306. doi: 10.1309/AJCP0TN1MCMOLMPK.
OBJECTIVES
Bone marrow can undergo necrosis for many different causes; malignant causes are reported to be more frequent.
METHODS
We undertook a 10-year retrospective review of all bone marrow biopsy specimens with bone marrow necrosis at our institution.
RESULTS
Identified cases represented approximately 0.3% of our bone marrow cases. Most identified bone marrow cases with necrosis were involved by metastatic tumor or hematolymphoid malignancy (90% of total) in relatively equal proportions. In those cases of bone marrow necrosis with hematolymphoid malignancy, lymphoid disease predominated and the necrosis was often seen in the setting of chemotherapy. In metastatic tumor cases, necrosis seemed to enrich in prostate adenocarcinoma and Ewing sarcoma/primitive neuroectodermal tumor; neuroblastoma showed much less necrosis. Ten percent of patients with bone marrow necrosis had no underlying malignancy, and the associated causes varied.
CONCLUSIONS
The causes of bone marrow necrosis are diverse but should always prompt careful assessment for malignancy and infectious etiology.
目的
骨髓坏死可由多种不同原因引起；据报道，恶性原因更为常见。
方法
我们对本机构所有存在骨髓坏死的骨髓活检标本进行了为期10年的回顾性研究。
结果
确诊病例约占我们骨髓病例的0.3%。大多数确诊的骨髓坏死病例由转移性肿瘤或血液淋巴系统恶性肿瘤引起（占总数的90%），比例相对均衡。在那些伴有血液淋巴系统恶性肿瘤的骨髓坏死病例中，淋巴系统疾病占主导，坏死常出现在化疗过程中。在转移性肿瘤病例中，坏死似乎在前列腺腺癌和尤因肉瘤/原始神经外胚层肿瘤中更为常见；神经母细胞瘤的坏死则少得多。10%的骨髓坏死患者没有潜在的恶性肿瘤，相关原因各不相同。
结论
骨髓坏死的原因多种多样，但总是需要对恶性肿瘤和感染病因进行仔细评估。
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