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骨髓坏死(Bone Marrow Necrosis)是指骨髓中的造血细胞发生原位性坏死,其原发病见于某些血液病,转移癌等,预后不良。本文就1978～1990年5月进行1853例骨髓涂片镜检中有8例骨髓坏死,报道如下。1 临床资料:患者中男5、女3,年龄2～45岁。其中急性白血病3例,慢性粒细胞白血病1例,慢性粒细胞白血病急性变2例,骨髓转移癌2例;均在明确骨髓坏死后短期内死亡或自动出院。临床表现主要与原发病有关,但全身持续性剧烈骨痛较明显,一般止痛药不能缓解;受累部位有明显的压痛;伴发热37.6℃～40.0℃;均有不同程度的贫血和出血。血徐片有6例白血病均可见到原始及幼稚细胞。各病例经髂骨穿刺1～4次,多为干抽,仅抽出少许“脓性”骨髓液,镜检特点是坏死,细胞结构模糊不清,胞膜破裂,浆溶解,核退变,细胞间满布片状及颗粒状嗜酸性、无结构物质,尚见少许散在完整细胞。
Bone Marrow Necrosis refers to the in situ necrosis of hematopoietic cells in the bone marrow. The primary disease is found in some hematological diseases, metastatic cancers and the like, and the prognosis is poor. This article from 1978 to 1990 in 1853 cases of bone marrow smear microscopy in 8 cases of bone marrow necrosis, reported as follows. 1 clinical data: male 5, female 3, aged 2 to 45 years old. There were 3 cases of acute leukemia, 1 case of chronic myeloid leukemia, 2 cases of acute myeloid leukemia and 2 cases of bone marrow metastasis; both died within a short period of time after definite bone marrow necrosis or were discharged automatically. Clinical manifestations mainly associated with the primary disease, but the whole body persistent severe pain was obvious, the general painkillers can not be relieved; affected parts have significant tenderness; fever 37.6 ℃ ~ 40.0 ℃; have varying degrees of anemia and bleeding. Blood Xu films have 6 cases of leukemia can be seen primitive and naive cells. The cases of iliac bone puncture 1 to 4 times, mostly dry pumping, only a small amount of “purulent” bone marrow fluid, the characteristics of microscopic examination is necrosis, cell structure obscure, cell membrane rupture, plasma lysis, nuclear degeneration, cells Between the full sheet and granular eosinophilic, no structural substances, but also see a little scattered in the whole cell.