Sutton Lisa, Mba Nkechi
1 Department of Pathology, Driscoll Children's Hospital, Corpus Christi, Texas, USA.
2 Department of Hematology and Oncology, Driscoll Children's Hospital, Corpus Christi, Texas, USA.
Pediatr Dev Pathol. 2017 Mar-Apr;20(2):172-175. doi: 10.1177/1093526616686241. Epub 2017 Jan 25.
Vitamin B12 deficiency is a known cause of megaloblastic anemia and bone marrow failure. Bone marrow biopsies are not frequently performed as part of the diagnostic workup and can demonstrate morphologic features that overlap with myelodysplastic syndrome (MDS) and acute leukemia. We describe a case of a dysplastic bone marrow with increased bone marrow hematogones detected by flow cytometry in a child with vitamin B12 deficiency. Hematogones are normal B cell precursors, and hyperplasia has been described in a variety of often reactive conditions and also disease. Hematogones are not typically seen in MDS. The presence of hematogones may help differentiate the dysplastic changes seen in vitamin B12 deficiency from MDS.
维生素B12缺乏是已知的巨幼细胞贫血和骨髓衰竭的病因。骨髓活检在诊断检查中并不常用，但其可显示出与骨髓增生异常综合征（MDS）和急性白血病重叠的形态学特征。我们描述了一例维生素B12缺乏儿童的发育异常骨髓病例，通过流式细胞术检测发现骨髓造血前体细胞增多。造血前体细胞是正常的B细胞前体，在多种通常为反应性的情况下以及疾病中都有增生的描述。MDS中通常看不到造血前体细胞。造血前体细胞的存在可能有助于将维生素B12缺乏时出现的发育异常变化与MDS区分开来。
