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目的:观察急性红白血病(AEL),骨髓异常增生综合征(MDS)及巨幼细胞性贫血(MA)骨髓象中淋巴样小巨核细胞及其他病态巨核细胞。方法:骨髓涂片,瑞特染色,低倍镜及油镜观察。对每例骨髓涂片进行巨核细胞(MK)计数,并做一系列组化染色,观察淋巴样小巨核细胞及其他病态巨核细胞的形态及阳性百分率。结果:MDS骨髓象中的淋巴样小巨核细胞、单圆核巨核细胞较AEL多见(P<0.05),与MA相比数量明显增多(P<0.01);MDS骨髓象中多圆核巨核细胞较AEL及MA增多(P<0.05);MA骨髓象中多分叶核巨核细胞检出率最高(P<0.01);MDS及AEL骨髓象中多圆核巨核细胞多<15μm,核形多规则,圆形且大小一致;MA骨髓象中,多圆核巨核细胞多>15μm,且核形以不规则和大小不一致居多。所有病例巨核细胞PAS染色,均为不同程度的阳性反应。结论:病态巨核细胞尤其是淋巴样小巨核细胞的出现对MDS和AEL等其他恶性血液系统疾病的鉴别诊断有着重要的价值。
Objective: To observe the lymphoid-like megakaryocytes and other pathological megakaryocytes in bone marrow of acute erythroleukemia (AEL), myelodysplastic syndrome (MDS) and megaloblastic anemia (MA). Methods: Bone marrow smear, Reiter staining, low magnification and oil lens observation. Megakaryocyte (MK) counts were performed on each bone marrow smear, and a series of histochemical staining was performed to observe the morphology and positive percentage of lymphoid-like megakaryocytes and other pathological megakaryocytes. Results: Compared with AEL group, the numbers of lymphoid megakaryoblastic cells and mononuclear megakaryocytes in MDS bone marrow were more common than those in AEL group (P <0.01), while those in MDS bone marrow megakaryocyte (P <0.05). The detection rate of multinucleated megakaryocytes in the bone marrow of MA was the highest (P <0.01). The number of multinucleated megakaryocytes in the bone marrow of MDS and AEL was more than 15μm, Round and the same size; MA bone marrow like, multi-nucleated megakaryocytes more than 15μm, and the nucleus to irregular and size inconsistent majority. All cases of megakaryocytes PAS staining, are different degrees of positive reactions. Conclusion: The appearance of morbid megakaryocytes, especially lymphoid megakaryocytes, is of great value in the differential diagnosis of other malignant hematological diseases such as MDS and AEL.