47例骨髓穿刺干抽的临床及病理分析

Clinicopathologic Analyses of Dry Tap Bone Marrow Aspirations in 47 Patients

作者分析该院发生的47例骨髓穿刺干抽的临床及病理改变,47例干抽占同期1319例骨髓穿刺的3.6％。根据骨髓细胞的密度和间质纤维增殖的程度,把干抽的原因分为4类:高细胞伴间质细胞增多19例(42.2％);间质细胞增多14例(1.1％);高细胞8例(17.8％)及低细胞4例(8.9％)。主要疾病为:急性淋巴细胞白血病(25.5％),急性非淋巴细胞白血病(17.0％),慢性白血病(14.9％),骨髓转移癌(10.6％),再障(6.4％),原发性骨髓纤维化(6.4％)。27例白血病占47例干抽的57.4％,其干抽原因与间质细胞增多和(或)高细胞性有关;骨髓转移癌的干抽与继发骨髓纤维化有关;再障的干抽与骨髓细胞显著减少有关。

47 cases of clinicopathologic changes in dry tap bone marrow aspirations were found in our hospital. Among 1 319 simultaneous bone marrow aspirations, 47 were 'dry tap '(3. 6%). According to the density of cells and degree of hyperplasia of interstitial fibers, the causes of 'dry tap 'were divided into four categories: high cell density associated with hyperplasia of interstitial cells 19 cases (42. 2%); hyperplasia of interstitial cells 14 cases (31. 1%); high cell density 8 cases (17. 8%); and low cell density 4 cases (8. 9%). The frequent diagnoses were a-cute lymphogenous leukemia (25. 5%),acute nonlymphogenous leukemia (17. 0%), chronic leukemia (14. 9%), metastatic carcinoma (10. 6%), aplastic anemia (6. 4%) and primary myelofibrosis (6. 4%). Of the 47 cases of 'dry tap ', 27 were leukemia (57. 4%). The cause of 'dry tap 'in leukemia had relation to hyperplasia of interstitial cells and /or high cell density : the cause of 'dry tap 'in metastatic carcinoma had relation to secondary myelofibrosis; and the cause of 'dry tap 'in aplastic anemia had relation to marked decrease of marrow cells