骨髓转移瘤的病理组织学与临床特点

Clinicohistopathologic features of metastatic tumor in bone marrow

目的 :研究骨髓转移瘤的临床和病理学特点。方法 :骨髓活检塑料包埋切片 ,H- Gmiesa- E,Gomori,PAS,Alcin blue染色。结果 :6 6例骨髓转移瘤中 ,低分化腺癌 42例、黏液腺癌 6例、黏液细胞癌 3例、低分化鳞癌9例、巨细胞癌 2例、未分化癌 2例、恶性黑色素瘤 1例、恶性纤维组织细胞瘤 1例。临床表现以贫血最常见(95 .1% ) ,其次为血小板减少 (5 9.5 % )和骨痛 (5 7.4% )。临床初诊常误诊为多发性骨髓瘤和其他血液病 ,仅 17例查到原发瘤部位 (2 5 .8% )。对转移瘤的病理与临床特点作了讨论。结论 :对于原发瘤尚不明确而已发生骨髓转移的肿瘤 ,骨髓活检具有重要诊断价值。

Objective:To study clinicohistopathologic features of bone marrow metastatic tumor(BMMT).Methods:Bone marrow biopsy plastic embedded section stained by H Giemsa E,PAS and Alcin blue.Results:Among 66 BMMTs were 42 poorly differentiated adenocarcinomas,6 mucinous adenocarcinomas,3 mucinous carcinomas,9 poorly differentiated squamous cell carcinomas,2 jiant cell carcinomas,2 undfferentiated carcinomas,and 1 melanoma and malignant fibrohistocytoma respectively.Anemia was mostly frequent clinical menifestation of BMMT,the secondary was thrombocytopenia( 59.5 %)and bone pain( 57.4 %).Multipl myeloma or other blood diseases were easily misdiagnosed .49( 74.2 %) primary tumor site were not found at present.Clinicopathologic features of BMMT ( 95.1 %) were discussed.Conclusion:Bone marrow biopsy is important for BMMT when primary tumor site is unknow.