Shin B M, Paik I K, Cho H I
Department of Clinical Pathology, Seoul Paik Hospital, Korea.
J Korean Med Sci. 1994 Feb;9(1):57-63. doi: 10.3346/jkms.1994.9.1.57.
The authors analysed bone marrow findings of sixteen cases of culture proven typhoid fever to reveal the pathologic changes according to the disease stage. The most frequent finding was chronic granulomatous inflammation (eight cases). Infection (bacteria) associated hemophagocytic syndrome (four cases), reactive marrow (two cases), and non specific findings (two cases) were also encountered. Granulocytic hyperplasia with hemophagocytosis appeared at the early stage and was followed by infection (bacteria) associated hemophagocytosis and granuloma in proliferative stage. In lysis (late) stage, granulomatous inflammation was noted. However, resolution of granulomatous inflammation was not distinct. Some nuclear debris and phagocytosis were remarkable in well-formed granulomas. Thrombocytopenia was the most remarkable peripheral blood finding at the time of biopsy. Anemia, leukopenia, and pancytopenia were also observed in descending order.
作者分析了16例经培养证实为伤寒热患者的骨髓检查结果，以揭示疾病不同阶段的病理变化。最常见的表现是慢性肉芽肿性炎症（8例）。还发现了感染（细菌）相关的噬血细胞综合征（4例）、反应性骨髓（2例）和非特异性表现（2例）。粒细胞增生伴噬血细胞现象出现在疾病早期，随后在增殖期出现感染（细菌）相关的噬血细胞现象和肉芽肿。在溶解期（晚期），可见肉芽肿性炎症。然而，肉芽肿性炎症的消退并不明显。在形成良好的肉芽肿中，一些核碎片和吞噬现象较为显著。活检时最显著的外周血表现是血小板减少。还依次观察到贫血、白细胞减少和全血细胞减少。
