Scudla V, Dusek J, Macák J, Zivná J, Myslivecek M, Indrák K
1st Medical Clinic University Hospital, Olomouc, Czechoslovakia.
Neoplasma. 1989;36(5):603-10.
Bone marrow necrosis (BMN) is a necrosis of the hemopoietic tissue including the fibrovascular medullary stroma. Most frequently, it is caused by failure of bone marrow microcirculation. It is a complication in a wide spectrum of diseases, most frequently of malignancies, and is only rarely diagnosed ante mortem. In 6 of our 7 intravitally diagnosed cases, BMN was recognized already at the cytological examination of the bone marrow and was verified by the histological examination of the biopsy specimens as well as at necropsy. All our patients suffered from various malignant diseases. Three had generalized gastric carcinoma, the remaining hematological neoplasias: Acute lymphoblastic leukemia, acute monocytic leukemia, blastic transformation of chronic granulomegakaryocytic myelosis and primary medullary centrocytic lymphoma. The survival varied from 4 to 14 weeks after the BMN diagnosis. Clinical, hematological and autopsy findings as well as the etiopathogenetic views and prognostic implications of the diagnosis are discussed.
骨髓坏死（BMN）是包括纤维血管性髓质基质在内的造血组织的坏死。最常见的原因是骨髓微循环衰竭。它是多种疾病的并发症，最常见于恶性肿瘤，生前很少被诊断出来。在我们7例经活体诊断的病例中，有6例在骨髓细胞学检查时就已发现骨髓坏死，并经活检标本的组织学检查以及尸检证实。我们所有的患者都患有各种恶性疾病。3例患有广泛性胃癌，其余为血液系统肿瘤：急性淋巴细胞白血病、急性单核细胞白血病、慢性粒巨核细胞骨髓增生症的原始细胞转化和原发性髓质中心细胞淋巴瘤。骨髓坏死诊断后，患者的存活时间为4至14周。本文讨论了临床、血液学和尸检结果，以及该诊断的病因发病学观点和预后意义。
