巨核细胞逸核和胞核胞质连体分离的形态学研究(英文)

Morphological Study on the Megakaryocytes with Nuclear Extrusion and Nucleocytoplasmic Separation in Four Cases

为了观察巨核细胞逸核和胞核胞质连体分离的形态学变化,用光镜观察4例初诊血液病患者的血片、骨髓涂片和骨髓切片中巨核细胞形态特征。4例初诊血液病患者为1例原发性骨髓纤维化(PMF),1例骨髓增生异常综合征(MDS),1例急性粒细胞白血病部分成熟型(M2)和1例红白血病(M6)。结果显示:在4例患者骨髓象中均观察到多种病态巨核细胞,其中例A(PMF)和例D(M6)多为撕拉分离状的病态巨核细胞;例B(MDS)和例C(M2)多为脱核的或胞核胞质分离状的病态巨核细胞,胞体大或巨大,部分胞核远离母体,有的残留少量胞质成为小(或)淋巴样巨核细胞,细胞免疫化学染色可显示分离的胞核胞质。结论:巨核细胞存在逸核和(或)胞核胞质分离现象,提示巨核细胞在成熟中存在多核胞核分散向周边逸去的过程,甚至完全脱离母体;微小巨核细胞可能是由多小核巨核细胞的胞核连胞质分离或分割而成的部分。

To investigate the morphological changes of megakaryocytes with nuclear extrusion and nucleocytoplasmic separation, the morphological characteristics of megakaryocytes in peripheral blood films, bone marrow smears, and bone marrow biopsies from 4 newly diagnosed patients with primary myelofibrosis （PMF）, myelodysplastic syndrome （MDS）, myeloblastic leukemia with maturation （M2） and erythroleukemia （M6） were studied by using light microscope. The results showed that many kinds of dysmegakaryocytes were observed in bone marrow smears of 4 cases,while in case A （PMF） and case D （M6） micromegakaryocytes were ripped apart; in case B （MDS） and case C （M2）megakaryocytes were accompanied by nuclear extrusion or nucleocytoplasmic separation, and their bodies were large or giant, the part of nucleus separated from their body and little cytoplasm remained as micromegakaryocytes. The nucleocytoplasmic separation could be displayed by immunocytochemistry stain. It is concluded that the phenomenon of nuclear extrusion and nucleocytoplasmic separation in megakaryocytes suggestsed the process that dispersed multinuclear releasing towards surround or even totally left the cell body during the megakaryocyte maturation. It also showed that the micromegakaryocytes may be the result of nucleocytoplasmic separation or splittings from multi-separated nucleus.