Spivak J L, Bender B S, Quinn T C
Am J Med. 1984 Aug;77(2):224-8. doi: 10.1016/0002-9343(84)90695-8.
Blood and marrow specimens were evaluated from 12 patients with the acquired immune deficiency syndrome (AIDS). Ten patients were anemic, eight leukopenic, and three thrombocytopenic. Pancytopenia was present in two patients and subsequently developed in two others. Reticulocyte counts were not increased in the anemic patients. The most common peripheral blood abnormalities were a left shift in the granulocyte series, lymphopenia, atypical lymphocytes, and vacuolated monocytes. Marrow cellularity was increased in five patients and reduced in three. Marrow reticulin was increased in 10 patients; in three of these, marrow could not be obtained by aspiration. Plasma cells were increased in number in every marrow aspirate, and there was a left shift in the myeloid series in most. Aggregates of atypical lymphocytes or a diffuse increase in marrow lymphocytes occurred in seven patients. An increase in histiocytes was observed in seven marrow aspirates; in five of these, the histiocytes were phagocytizing red cells, white cells, and platelets. Necrosis was present in four marrow specimens. These hematologic abnormalities reflect, in part, the presence of systemic infection, inflammation, and the inanition associated with them. However, the high incidence of myelofibrosis, alterations in marrow cellularity, pancytopenia, and hematophagic histiocytosis indicates that the bone marrow is a target organ in AIDS.
对12例获得性免疫缺陷综合征（AIDS）患者的血液和骨髓标本进行了评估。10例患者贫血，8例白细胞减少，3例血小板减少。2例患者全血细胞减少，另有2例随后出现全血细胞减少。贫血患者的网织红细胞计数未增加。最常见的外周血异常是粒细胞系左移、淋巴细胞减少、非典型淋巴细胞和空泡化单核细胞。5例患者骨髓细胞增多，3例减少。10例患者骨髓网状纤维增加；其中3例无法通过穿刺获取骨髓。每个骨髓穿刺物中的浆细胞数量均增加，大多数患者的髓系左移。7例患者出现非典型淋巴细胞聚集或骨髓淋巴细胞弥漫性增加。7例骨髓穿刺物中观察到组织细胞增多；其中5例组织细胞吞噬红细胞、白细胞和血小板。4例骨髓标本存在坏死。这些血液学异常部分反映了全身感染、炎症以及与之相关的营养不良的存在。然而，骨髓纤维化的高发生率、骨髓细胞增多的改变、全血细胞减少和噬血细胞组织细胞增多表明骨髓是AIDS的靶器官。
