Ikegami T, Hasegawa Y, Hanada T, Nakazawa M, Abe T
Rinsho Ketsueki. 1989 Jun;30(6):898-903.
Diagnostic significance of the megakaryocyte markers and clinical findings were evaluated in three cases with chronic myelogenous leukemia in megakaryoblastic crisis. Platelet peroxidase (PPO), glycoprotein IIb/IIIa, Ib, von Willebrand factor antigen (vWF: Ag) and demarcation membrane system (DMS) were examined as the megakaryocyte markers. Blast phenotypes were as follows: PPO- IIb/IIIa+ vWF: Ag+ DMS+ in Case 1, PPO+ IIb/IIIa +/- Ib- vWF: Ag +/- in Case 2 and PPO+ IIb/IIIa+ vWF: Ag +/- DMS +/- in Case 3 (-: 0% +/-: less than 10% +: greater than or equal to 10%). In Cases 1 and 3, no markers other than those for the megakaryocyte lineage were detected, but myeloperoxidase-positive blasts coexisted with PPO-positive megakaryoblasts in Case 2. Megakaryoblast phenotypes and involvement of other lineages were much different in each case. Therefore, marker study for cytological diagnosis should be performed in consideration of lineage heterogeneity. As to the clinical findings, no clear features common to the three cases were present. However, multiple osteolytic lesions were demonstrated on bone survey in Case 1 and considered to be caused by the proliferation of megakaryoblasts.
对3例慢性粒细胞白血病急巨核细胞变患者的巨核细胞标志物及临床发现的诊断意义进行了评估。检测了血小板过氧化物酶（PPO）、糖蛋白IIb/IIIa、Ib、血管性血友病因子抗原（vWF:Ag）和分界膜系统（DMS）作为巨核细胞标志物。原始细胞表型如下：病例1为PPO-IIb/IIIa+vWF:Ag+DMS+，病例2为PPO+IIb/IIIa+/-Ib-vWF:Ag+/-，病例3为PPO+IIb/IIIa+vWF:Ag+/-DMS+/-（-：0%；+/-：小于10%；+：大于或等于10%）。在病例1和病例3中，除了巨核细胞系标志物外未检测到其他标志物，但病例2中髓过氧化物酶阳性的原始细胞与PPO阳性的巨核母细胞共存。每个病例的巨核母细胞表型及其他谱系受累情况差异很大。因此，应考虑谱系异质性进行细胞诊断的标志物研究。关于临床发现，这3例患者没有明显的共同特征。然而，病例1的骨检查显示有多处溶骨性病变，考虑是由巨核母细胞增殖引起的。
