Shiozaki H, Iwahashi C, Suzuki T, Miyoshi K, Kurane R, Yamato K, Enomoto Y
Rinsho Ketsueki. 1989 Oct;30(10):1806-9.
We report a case of acute myelofibrosis (AMF) developing into acute myelomegakaryoblastic leukemia. A 33-year-old woman was admitted to our hospital because of fever and chest pain. On physical examination, hepatosplenomegaly was not noticed. Pancytopenia and a small number of blast cells were observed in the peripheral blood. Poikilocytosis was not detected. Bone marrow examination revealed dry tap on aspiration, and moderate increase in reticulin fiber on biopsy. The diagnosis of AMF was made. Eight months later, blast cells markedly increased. Surface marker was investigated and MCS-2 (CD13), C17 (CDw41) and P2 (CDw41) were found to be positive. Electron microscopic examination revealed that blast cells were composed of PPO-positive cells and MPO-positive cells. Based on these findings, it was considered that the patient developed acute myelomegakaryoblastic leukemia. Recently AMF is thought to be a state to have the ability to develop into various types of acute leukemia. Adequate therapy may be required before the development of leukemia.
我们报告了一例急性骨髓纤维化（AMF）发展为急性巨核细胞白血病的病例。一名33岁女性因发热和胸痛入院。体格检查未发现肝脾肿大。外周血中观察到全血细胞减少和少量原始细胞。未检测到异形红细胞。骨髓穿刺检查显示干抽，活检显示网状纤维中度增加。诊断为AMF。八个月后，原始细胞明显增多。进行了表面标志物检测，发现MCS-2（CD13）、C17（CDw41）和P2（CDw41）呈阳性。电子显微镜检查显示原始细胞由PPO阳性细胞和MPO阳性细胞组成。基于这些发现，认为该患者发展为急性巨核细胞白血病。最近，AMF被认为是一种有能力发展为各种类型急性白血病的状态。在白血病发生之前可能需要适当的治疗。
