Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China.
J Clin Lab Anal. 2020 Sep;34(9):e23372. doi: 10.1002/jcla.23372. Epub 2020 Jun 16.
Bone marrow smear and biopsy are the main methods for the diagnosis of multiple myeloma (MM), bone marrow infiltration, and metastasis in lymphoma and cancer. However, several factors, including the focal growth of tumor cells, inappropriate puncture sites, and hemodilution of bone marrow aspirates, lower the rate of target cell detection. To solve this problem, we developed a novel method-bone marrow particle enrichment analysis-and here, we describe this procedure and its use in the diagnosis of a rare case of MM.
An 88-year-old man with primary gastric gamma delta T-cell lymphoma (γδTCL) was found to have anemia. As the cause of anemia could not be determined, hemodilution was suspected, warranting the re-examination of the bone marrow aspirate. Re-puncture could not be performed because of the patient's age and unwillingness to undergo this procedure. Hence, we used a novel approach to enrich bone marrow particles and isolate marrow cells, and subsequently performed morphological and flow cytometric analysis.
Examinations performed after bone marrow particle enrichment revealed the presence of myeloma cells, and the patient was diagnosed with primary gastric γδTCL accompanied by MM.
Bone marrow particle enrichment analysis may be applied to overcome the problems caused by hemodilution of bone marrow aspirates and to improve the rate of tumor cell detection. The application of this method for the diagnosis of hematological disorders should be explored further.
骨髓涂片和活检是多发性骨髓瘤（MM）、淋巴瘤和癌症中骨髓浸润和转移的主要诊断方法。然而，包括肿瘤细胞局灶性生长、穿刺部位不当和骨髓抽吸物血液稀释在内的几个因素降低了靶细胞检测的阳性率。为了解决这个问题，我们开发了一种新的方法——骨髓颗粒富集分析，并在此描述该方法及其在一例罕见 MM 诊断中的应用。
一名 88 岁男性患有原发性胃γδT 细胞淋巴瘤（γδTCL），出现贫血。由于无法确定贫血的原因，怀疑存在血液稀释，需要重新检查骨髓抽吸物。由于患者年龄较大且不愿接受该操作，故无法进行再次穿刺。因此，我们采用了一种新的方法来富集骨髓颗粒并分离骨髓细胞，随后进行形态学和流式细胞术分析。
骨髓颗粒富集分析检查显示存在骨髓瘤细胞，患者被诊断为原发性胃γδTCL 伴发 MM。
骨髓颗粒富集分析可用于克服骨髓抽吸物血液稀释引起的问题，提高肿瘤细胞的检出率。应进一步探索该方法在血液系统疾病诊断中的应用。
