MDS-RA、MgA与M6的骨髓细胞形态学鉴别诊断

Differential diagnostic of bone marrow morphocytology in the patients with MDS-RA,MgA and M6

目的:分析MDS-RA、MgA及M6患者骨髓细胞形态特点,以提高对相关疾病的认识。方法:对在我院及上海瑞金医院确诊的25例MDS-RA,MgA及M6患者的骨髓细胞形态进行分析。结果:MDS-RA骨髓增生活跃或明显活跃,偶见增生减低,粒红比常减低,常见两系以上病态;MgA骨髓增生明显活跃,粒红比常减低,粒红两系出现巨幼样变;M6骨髓增生明显活跃,粒红比常倒置,红系明显病态,原始细胞增多。结论:MDS-RA,MgA及M6的骨髓象共同点:都会出现红系明显增生,出现巨幼样病态改变。不同点:MDS-RA与M6主要是各系病态造血明显,通常以原始细胞比例不同进行鉴别,而MgA主要表现为各系的巨幼样变,且原始细胞比例不高。

Objective：To analyze the bone marrow morphocytology in the patients with MDS-RA,MgA and M6,deepen our understanding of related diseases.Methods：25 cases diagnosed in our hospital and Shanghai Ruijin Hospital were analyzed.Results：MDS-RA of the bone marrow showed active or significantly active proliferation,occasionally showed hypoplasia.The ratio of G/E in bone marrow often reduced and more than two series were dysplastic.MgA of the bone marrow showed significantly active proliferation.The ratio of G/E in bone marrow often reduced and the bone marrow cells had a change of giants.M6 of the bone marrow showed significantly active proliferation.The ratio of G/E in bone marrow were often inverse.Erythrocytes were significantly dysplastic and the more ratio of blastocytes was found.Conclusion：MDS-RA,MgA and M6 of the bone marrow showed in common that erythrocytes were significantly active proliferation and the bone marrow cells had a change of giants.The differentia shows that the bone marrow of MDS-RA and M6 are dysplastic and have the different ratio of blastocytes.The bone marrow cells of MgA have a change of giants and the ratio of blastocytes is not high.