骨髓增生异常综合征难治性贫血与巨幼细胞贫血细胞形态学比较

The Morphocytologic Comparison of Myelodysplastic Syndronre-refractory(MDS-RA) and Megaloblastic Anemia(MA)

目的通过对骨髓增生异常综合征--难治性贫血(MDS-RA)和巨幼细胞贫血(MA)进行细胞形态学比较,提高其诊断与鉴别水平。方法对23例MDS-RA与28例MA患者进行常规骨髓穿刺涂片,进行瑞氏染色光学显微镜下观察比较。结果MDS-RA以双核红细胞及奇数核红细胞、淋巴样小巨核最有特征。MA骨髓红系呈明显的“幼核老浆”改变;粒系以中幼粒以下各阶段细胞巨型改变;未发现淋巴杆小巨核细胞。结论淋巴样小巨核细胞是MDS-RA主要特征;MA骨髓细胞呈”幼核老桨”,并以红系为明显。

Objective To improve the level of diagnosis and idehtification diagnosis of MDS-RA by their morphocytologic comparison.Methods The normal bone marrow smears of 23 cases with MDS-RA and 28 cases with MA were stained by Wright's staining,and then observed by optical microscope and compared.Results Odd nucleus,great red cell and lymphoid small macronucleus have great diagnosis value in MDS-RA;`Juvenile nucleus and senile cytolipin'especially in the red series-is the character of MA,while the granule series have a change of megakaryoblast in each stage after myeloayte.No lymphoid small megakaryocyte had been found.Conclusion Lymphoid small megakaryocyte is the main characteristic of MDS-RA;MA had a characteristic of `juvenile nucleus and senile cytolipin',especially in the red series.