Yuen Lisa D, Hasserjian Robert P
Department of Pathology-WRN 244, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Department of Pathology-WRN 244, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Clin Lab Med. 2023 Dec;43(4):577-596. doi: 10.1016/j.cll.2023.06.003. Epub 2023 Aug 9.
Morphologic characterization remains a cornerstone in the diagnosis and classification of myelodysplastic syndromes (MDS) in the updated International Consensus Classification (ICC) and 5th edition World Health Organization Classification of Myeloid Neoplasms (Arber, Orazi, & Hasserjian, 2022; Khoury & Solary, 2022). The presence of dysplasia is one of the key diagnostic criteria required for establishing a diagnosis of MDS, and the percentage of myeloblasts in the blood and bone marrow impacts both disease classification and prognostication. Morphologic features also aid in distinguishing MDS from a myriad of other myeloid neoplasms and non-neoplastic mimics. Additional key morphologic features that should be recorded in any MDS case are the bone marrow cellularity and the degree of reticulin fibrosis. In this review, the morphologic assessment of the bone marrow biopsy, bone marrow aspirate, and peripheral blood smear as it pertains to the diagnosis and up-to-date classification of MDS will be described. The implications of the findings on classification and prognosis will also be discussed.
在更新后的国际共识分类（ICC）和世界卫生组织髓系肿瘤第5版分类中，形态学特征仍然是骨髓增生异常综合征（MDS）诊断和分类的基石（阿伯、奥拉齐和哈塞尔简，2022年；库里和索拉里，2022年）。发育异常的存在是建立MDS诊断所需的关键诊断标准之一，血液和骨髓中原始粒细胞的百分比会影响疾病分类和预后。形态学特征也有助于将MDS与众多其他髓系肿瘤和非肿瘤性模仿疾病区分开来。任何MDS病例都应记录的其他关键形态学特征是骨髓细胞密度和网硬蛋白纤维化程度。在本综述中，将描述骨髓活检、骨髓穿刺和外周血涂片的形态学评估，及其与MDS诊断和最新分类的关系。还将讨论这些发现对分类和预后的影响。
