骨髓增生异常综合征40例病理观察分析

The pathologic objection and analysis of the 40 cases myelodysplastic syndrome

目的观察分析骨髓增生异常综合征(MDS)的骨髓病理表现。方法采用骨髓活检方法取髂后上棘骨髓组织40例,进行固定、脱钙、石蜡包埋、切片、HE染色,观察骨髓增生程度,红细胞(红系)、粒细胞(粒系)、巨核细胞(巨核系)三系髓细胞及间质的病理改变。结果骨髓增生极度活跃30%,明显活跃42.5%,增生活跃7.5%,增生减低20%;三系病态造血是红系67.5%,粒系62.5%,巨核系85%;95%骨髓可见幼稚前体细胞异常定位(ALIP)现象;间质改变17.5%;MDS合并骨髓纤维化3例(7.5%)。结论骨髓细胞的病态造血是MDS诊断的主要依据;ALIP现象和小巨核细胞出现是MDS诊断的重要依据;骨髓活检对MDS的诊断及判断预后具有重要意义。

Objective To observe and analyze the pathologic change on myelodysplastic syndrome （MDS） . Methods Fourty cases patient＇s bone marrow biopsy tissues from posterior superior iliac spines are fixated, decalcified, paraffin embedaled, sected, hematoxylin-eosin stained, microscopic examinated sections to observe marrow hyperplasia degrees, erythrocytes, granulocytes, megakaryocytes three lines hematopoietic cell and stroma pathologic change. Results Marrow extremely hyperplasia are 30%, obvious hyperplasia are 42.5%, hyperplasia active are 7.5%, hyperplasia reduction are 20% ; three lines abnormal hematopoietic cells： erythrocytes are 67.50%, granulicytes are 62.50%, megakaryocytes are 85%; 95% merrow can be seen ALIP phenomenon; stroma charge are 17.50//00; MDS conbinning bone fiberosis have 3 cases （7. 5%）. Conclusions Marrow abnormal hematopoietic cell is main diagnostic basis to MDS, ALIP phenomenon and small megakaryocyte cell is important diagnostic basis, marrow biopsy has important significance to MDS diagnosis and judge prognosis.