O'Keane J C, Wolf B C, Neiman R S
Hematopathology Section, Mallory Institute of Pathology, Boston, MA 02118.
Cancer. 1989 Apr 15;63(8):1539-43. doi: 10.1002/1097-0142(19890415)63:8<1539::aid-cncr2820630814>3.0.co;2-5.
Splenic extramedullary hematopoiesis (EMH) is a characteristic finding in agnogenic myeloid metaplasia (AMM) and in the spent phase of polycythemia vera (PV). Evidence from our laboratory has suggested that splenic EMH in these conditions results from the filtration of circulating hematopoietic cells from the peripheral blood and does not arise de novo from splenic stem cells. To further test this hypothesis, 31 autopsy and 26 surgical cases of carcinoma metastatic to the bone marrow were studied. The presence of leukoerythroblastosis (LEB) correlated with intravascular hematopoiesis (IVH) in the bone marrows associated with reticulin fibrosis, and with splenic EMH in the autopsy cases. These studies provide evidence that stromal changes in the bone marrow with resulting IVH, LEB, and splenic EMH are not unique to AMM and PV but also occur in such unrelated conditions as metastatic carcinoma, and suggest that these phenomena are causally related.
脾脏髓外造血（EMH）是原发性骨髓化生（AMM）以及真性红细胞增多症（PV）终末期的一个典型表现。我们实验室的证据表明，在这些情况下，脾脏EMH是由外周血中循环造血细胞的滤过所致，并非源自脾脏干细胞的重新生成。为了进一步验证这一假设，我们研究了31例骨髓转移性癌的尸检病例和26例手术病例。幼稚粒-幼红细胞血象（LEB）的出现与伴有网状纤维纤维化的骨髓中的血管内造血（IVH）相关，并且在尸检病例中与脾脏EMH相关。这些研究提供了证据，表明骨髓中的基质变化导致的IVH、LEB和脾脏EMH并非AMM和PV所特有，也发生在诸如转移性癌等不相关的病症中，并提示这些现象存在因果关系。
