全髓白血病的骨髓超微结构及细胞化学观察

Observation of Bone Marrow from Two Panmyelosis Leukemia Patients by Electron Microscopy and Cytochemistry

全髓白血病是以红、白、巨核3系细胞同时异常增生的一种罕见的特殊类型白血病。本文对2例临床已确诊的全髓白血病患者的骨髓标本用透射电镜、扫描电镜、髓过氧化物酶(MPO)、血小板过氧化物酶(PPO)反应进行观察。发现红、粒、单、巨核细胞均有大量原始及幼稚细胞,以粒细胞系占优势。红细胞的主要病变为胞膜的“花瓣”样或小球样变,其次核膜腔扩张;粒、单核系的超微结构改变和单系(“急粒”或“急单”)白血病细胞相似;巨核系见到许多体积比正常巨核小的小巨核细胞。本文对4系细胞的超微结构改变,以及与红白血病的关系进行讨论。

Bone marrow cells from 2 patients with panmyelosis leukemia were observed with transmission electron microscopy (TEM),scanning electron microscopy (SEM),myeloperoxidase (MPO) and platelet peroxidase (PPO).A lot of immature cells were found in the granulocytic, monocytic,erythrocytic and megakaryocytic series.Their major morphologic characteristics were as follows. In the erythrocytic series, petaloid-like and ball-like structure appeared and their perinuclear cisters were wider. In the myelomonocytic series, nuclear-cytoplasmic organelle asynchrony could be seen makedly and the nucleus appeared fully mature, but the cytoplasm contained only a few organelles, and in some cells the organells were often locally distributed. In the megakaryocytic series, many micromegakaryocytes were seen. In this paper, the ultrastructura] changes of four kinds of cells and their relationship with erythro-leukemia are also discussed.