Delacrétaz F, Perey L, Schmidt P M, Chave J P, Costa J
Institut de Pathologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Virchows Arch A Pathol Anat Histopathol. 1987;411(6):543-51. doi: 10.1007/BF00713285.
The clinical and haematological findings in 18 patients with human immunodeficiency virus (HIV) infection were correlated with the histological features of plastic embedded bone marrow biopsies. Fifteen patients presented with peripheral cytopaenia of one or several cell lines. Twelve (66%) of the 18 patients exhibited bone marrow findings including normo- to hypercellularity, myelodysplasia, lymphocytosis with or without plasmacytosis and fibrosis of the reticulin type. Seventeen patients had myelodysplastic features, 5 of the 3 haematopoietic lines, 10 of 2 lines and 2 of 1 line. Dysmegakaryocytopoiesis and dyserythropoiesis, seen in 88% and 83% of the 18 patients respectively, were the most common myelodysplastic features. Bone marrow gelatinous transformation (serous atrophy) was a conspicuous finding in 7 (38%) of the 18 patients. The constellation of histological features here described, although not pathognomonic, is highly suggestive of HIV infection. The pathogenesis of the haematological abnormalities in HIV infection is discussed.
对18例人类免疫缺陷病毒（HIV）感染患者的临床和血液学检查结果与塑料包埋骨髓活检的组织学特征进行了相关性分析。15例患者出现一种或几种细胞系的外周血细胞减少。18例患者中有12例（66%）表现出骨髓检查结果，包括正常细胞至细胞增多、骨髓发育异常、淋巴细胞增多伴或不伴浆细胞增多以及网状纤维型纤维化。17例患者有骨髓发育异常特征，3个造血系中有5例，2个系中有10例，1个系中有2例。18例患者中分别有88%和83%出现巨核细胞生成异常和红细胞生成异常，这是最常见的骨髓发育异常特征。骨髓胶样变性（浆液性萎缩）在18例患者中有7例（38%）表现明显。本文描述的组织学特征组合虽不具有特异性，但高度提示HIV感染。文中讨论了HIV感染时血液学异常的发病机制。
