Ito Masafumi
ITO. MD Pathology Laboratory.
Japanese Red Cross, Aichi Medical Center Nagoya Daiichi Hospital, Department of Pathology.
Rinsho Ketsueki. 2024;65(8):778-783. doi: 10.11406/rinketsu.65.778.
Identification of driver genes and pathological bone marrow diagnosis were considered essential for subclassification of MPN in the revised 4th edition of the WHO classification, and this remained nearly unchanged in the 5th edition. Pathological diagnosis of primary myelofibrosis/pre-fibrotic stage by biopsy is now feasible and is becoming standardized. Progressive myelofibrosis and blast transformation are the advanced forms of MPN, and various therapeutic interventions for these forms have been devised. Observation of activated megakaryocytes on evaluation of megakaryocyte morphology could predict the progression of myelofibrosis. This paper describes recent progress in pathological diagnosis of MPN and how it is performed in practice.
在世界卫生组织(WHO)分类第4版修订版中,确定驱动基因和进行骨髓病理诊断被认为是骨髓增殖性肿瘤(MPN)亚分类的关键,在第5版中这一点几乎没有变化。目前,通过活检对原发性骨髓纤维化/纤维化前期进行病理诊断是可行的,并且正在走向标准化。进行性骨髓纤维化和原始细胞转化是MPN的晚期形式,针对这些形式已经设计了各种治疗干预措施。在评估巨核细胞形态时观察活化的巨核细胞可以预测骨髓纤维化的进展。本文描述了MPN病理诊断的最新进展以及在实际中如何进行诊断。