急性髓性白血病骨髓切片FAB分型的应用及其与涂片之比较

A HISTOPATHOLOGICAL STUDY OF BONE MARROW FOR ACUTE MYELOID LEUKEMIA ANDTHE FAB CLASSIFICATION (MODIFICATION)APPLIED TO BONE MARROW BIOPSY SPECIMENS AND COMPARISON WITH BONE MARROW SMEARS

报道42例急性髓性白血病(AML)骨髓活检切片改良FAB分类之结果,并与涂片作比较,证明两种标本的M_3型一致,涂片M_(2a)较切片为高,切片内M_4亚型较涂片为高,42例中的13例切片内原始细胞数较涂片为高,提示活检切片对涂片起有补充与纠正作用。

We report the modified FAB classification of bone marrow biopsy specimens and comparison with bone marrow smears,taken simultaneously from 42 patients with acute myeloid leukemia (AML). A considerable difference was observed between the results of one--step aspirate smears and the findings of biopsy section. Concordance between the aspirate and biopsy specimen M_3 was observed in 13 cases. But the cases of myeloblastic leukemia with maturation (M_(2a)) in aspirate smears was higher than that estimated in the sections(13: 9), whereas the cases of myelomonocytic (M_4) variety was higher in section than in the aspirate smears (6: 4). Three of the 13 cases classified as M_(2a) on the aspirate showed some cells with morphological features of monoblasts in the sections and suggest M_4. The absence of monocytic components in smears may be an example of selective resistance to aspiration. A considerable difference in the extent of blast cell infiltration was also observed between the smears and sections. In thirteen of the 42 cases the extent of cell infiltration was higher in sections than in the smears. Our study shows that bone marrow biopsy complements and corrects the findings of marrow aspiration in the classification of AML.