骨髓涂片结合骨髓活检在血液病诊断中的应用

目的:探讨骨髓涂片结合骨髓活检对血液病诊断的应用价值.方法:采用骨髓抽吸和活检同步取材,涂片采用常规细胞化学染色,切片采用塑料包埋,常规化学染色进行骨髓增生程度和细胞形态学观察.结果:对于造血系统肿瘤(包括急性白血病、恶性淋巴瘤、多发性骨髓瘤)、造血干细胞疾病(包括再生障碍性贫血、骨髓增生异常综合征)、骨髓转移癌诊断的符合率,活检高于涂片;对于骨髓增殖性肿瘤(包括原发性骨髓纤维化、真性红细胞增多症、原发性血小板增多症)、增生性贫血(包括巨幼细胞性贫血、缺铁性贫血、继发性贫血)、特发性血小板减少性紫癜诊断的符合率,涂片高于活检.结论:二者同步分析能优势互补,提高血液病的诊断率.     

骨髓活检在诊断骨髓异常增生综合征中的意义

目的　分析骨髓活检在骨髓异常增生综合征诊断中的意义。方法　比较 4 0例骨髓穿刺涂片及骨髓活检组织切片的结果。结果　在骨髓活检组织切片中所见的白细胞及红细胞的异常结果与骨髓穿刺涂片大致相仿 ,但其能比骨髓穿刺涂片更早的发现白细胞早期细胞的异常定位 /集落 ,网状纤维的出现。当然 ,骨髓穿刺涂片在对细胞异常的观察有其更细致的优势。结论　在骨髓穿刺涂片不能确认骨髓异常增生综合征时进行骨髓活检有其明显的意义。     

骨髓转移癌形态特征及临床意义

目的:探讨与分析骨髓转移癌的形态学特征及临床意义,提高对该疾病的诊疗水平。方法:分析7例骨髓转移癌患者的临床表现及骨髓特点。结果:骨髓涂片血液学改变往往是骨髓转移癌最早的临床表现,而骨髓穿刺是一项简单而有效的诊断方法。结论:当临床出现病因不明的贫血、发热、消瘦、骨痛,外周血涂片出现幼红、幼粒细胞等,应考虑骨髓转移癌可能,早行骨髓穿刺检查,骨髓涂片形态学检查尤为重要,应同时进行骨髓活检,实现相互补充,使阳性率得到提高,以免误诊、漏诊。     

骨髓涂片对慢性骨髓增殖性疾病的诊断价值

目的探讨骨髓涂片对慢性骨髓增殖性疾病(MPD)的诊断价值。方法选择80例MPD患者,均采用骨髓活检-抽吸双样本同步取材,抽吸的髓液常规制成涂片,活检样本制成切片;分析骨髓涂片和骨髓切片的巨核细胞及巨核细胞簇形态特征及检出率。结果骨髓涂片与骨髓切片对各类型巨核细胞检出率比较差异均无统计学意义;骨髓涂片对A型检出率显著高于B型、C型(P0.05),骨髓切片对C型检出率显著高于A型、B型(P0.05)。结论骨髓涂片适于观察形态学改变,骨髓切片适于观察结构改变,将两者综合分析,能够为MPD的诊断提供更加准确的信息。     

骨髓活检对再生障碍性贫血诊断意义探讨

回顾分析对比我院血液科 1998年 1月～ 1999年 6月共 2 5例住院再障患者的临床、骨髓涂片、骨髓活检资料。以期探讨骨髓活检对再障的诊断意义。1　对象共收集了 2 5例 1998年 1月～ 1999年 6月住院再障患者的临床、骨髓涂片、骨髓活检资料。其中男性 16例 ,女性 9例 ;平均年龄 3 9( 15～ 5 4)岁 ;急性再障 10例 (包括重型再障 1型 4例 ,重型再障Ⅱ型 6例 ) ,慢性再障 15例 (轻型再障 )。所有病例均符合 1987年全国再障会议修订诊断标准[1] ,经临床、血生化、血象、骨髓检查确诊。2　方法2 .1　骨髓涂片　 2 5例患者均行 2次及以上不同部位骨…     

多发性骨髓瘤的骨髓病理观察

目的　评估骨髓活检在多发性骨髓瘤诊断、分型的价值。方法　分析74例多发性骨髓瘤患者的骨髓涂片与切片的观察结果。结果　骨髓活检病理观察对于诊断多发性骨髓瘤,尤其在分型中有很大帮助。结论　骨髓活检是确诊早期多发性骨髓瘤及其分型必不可少的检测手段。     

重度苯中毒骨髓检查及其临床诊断价值的研究

目的探讨骨髓涂片及活检对重度苯中毒的诊断和鉴别诊断意义.方法对46例重度苯中毒进行骨髓穿刺,取骨髓液及活体组织进行研究.结果 46例有23例骨髓像符合再生障碍性贫血(AA)的典型表现,11例为可疑AA.苯中毒患者的骨髓涂片中粒红比值、巨核细胞数量随着骨髓增生程度降低而降低.结论骨髓活检结合涂片检查对苯中毒的病情及诊断可作较为全面的综合评价.     

骨髓细胞增生低下涂片和切片的对比研究

利用骨髓穿刺涂片进行细胞形态学检查 ,是血液病的主要诊断方法之一。但是我们发现部分病例骨髓涂片显示的细胞增生低下与其临床诊断常不相符。为了探讨导致骨髓涂片中细胞增生低下的原因 ,我们患者的同期同部位骨髓活检组织切片进行了比较观察 ,现将结果报告如下。材料与方法1　病例选择　收集 1996～ 2 0 0 1年期间 78例骨髓涂片检查示细胞增生低下患者男 36例、女 4 2例 ;年龄 13～ 79岁 ,中位年龄 4 6岁。2　标本制备　对 78例患者骨髓涂片作瑞氏染色 ,骨髓活检标本的制备采用石腊包埋半薄切片法 ,切片行HE染色 ,部份标本采用网状纤维…     

形态学联合流式细胞术对淋巴瘤骨髓浸润的应用

目的探讨形态学检查联合流式细胞术(FCM)对淋巴瘤骨髓浸润的临床应用。方法对77例淋巴瘤患者的骨髓标本行FCM免疫表型、涂片及活检,观察骨髓受累率,并初步评价其临床价值。结果 11例霍奇金淋巴瘤(HL)切片法仅发现1例骨髓受累;66例非霍奇金淋巴瘤(NHL)中,FCM检出41例,涂片法检出8例,切片法检出19例。FCM发现的41例中,18例为早期浸润(瘤细胞5%);20例为小细胞淋巴瘤(SLL);2例为浆细胞性淋巴瘤,2例为滤泡性淋巴瘤,1例同时表达T、B细胞抗原。结论形态学联合FCM检查提高了骨髓受累的检出率,免疫表型对早期浸润和SLL有重要诊断价值。     

骨髓活检技术操作方法与要领

目的探讨骨髓活检的操作成功的方法和要领。方法对492例骨髓活检的操作过程进行总结。结果492例骨髓活检中除1例骨髓纤维化和1例慢性淋巴细胞性白血病引起骨髓纤维组织增生干抽,而不能作抽吸物涂片外,其余病例均顺利完成涂片和活检双重操作,骨髓液无稀释,活检骨髓组织符合要求,麻醉效果好,术后无创口感染及不良反应。结论要使骨髓活检操作穿刺顺利、病人痛苦少、取材成功率高、局部创口愈合良好,必须做到定位准确、麻醉过硬、手法正确、术后处理好穿刺部位。     

Chondroblastoma of bone

Background: Chondroblastoma is a rare and benign cartilaginous tumor of bone often localized in the epiphysis of long bones and affecting young persons between 10 and 20 years. Aim: To study the epidemiological, clinical and radiological aspects of bone chondroblastoma, to assess the outcome of chirurgical treatment and factors associated with recurrence. Methods: It's a retrospective study, concerning 13 patients with chondroblastoma of bone, attending the orthopedic department of Sahloul hospital between 1991 and 2007. The patients' age, sex, clinical features, radiological aspects, treatment and evolution were recorded. After initial clinical examination, all patients have had plane radiographs. Twelve patients were explored by Computed tomography. The treatment was surgical in every case: curettage of the lesion in 11 cases associated with bone grafting in 5 cases and cementation in one case, one in-bloc resection and one simple biopsy. Histology confirmed the diagnostic in all cases. Résultats: The average age of patients was 18, 2 years and sex ratio was 2, 3. the long bones are the most commonly involved. The main presenting symptoms were pain in all cases and local swelling in 8 cases. Radiographs showed a lytic geographic well-defined lesion in 7 cases. Computed tomography showed better calcifications and soft tissue extension. The mean follow-up of our patients was 8 years (6 mois-18 ans). Two recurrences were noted. Functional results were good in 11 cases. Conclusion: Chondroblastoma is a rare and benign cartilaginous tumor of bone which usually involves the epiphysis of long bones. Plane radiographs are sufficient for diagnostic in typical cases. MRI is interesting in unusual presentations and localizations. Curettage and grafting constitute the treatment of choice. Prognosis depends basically on a relatively high rate of recurrence. Aggressive feature of the lesion and incomplete curettage are the most important predictive factors of recurrence.     

Effect of dietary calcium deficiency on bone matrix-induced ectopic bone

The effect of dietary depletion of calcium on collagenous bone matrix-induced ectopic bone was studied, following thirty days of deficiency. While the molar ratio of phosphorus and calcium did not exhibit any significant differences between the control and experimental groups, individual concentrations of these minerals showed significant reduction in the ossicles derived from experimental rats. A concomitant decrease and increase in urinary excretion of calcium and phosphate was noted in the calcium deficient group; the serum levels of these parameters, however, were not affected. Both hexosamine and hydroxyproline levels appeared higher in calcium deficient ossicles. A significant elevation of alkaline and acid phosphatase as well as aryl sulfatase was observed in calcium deficient ossicles. There appeared to be no difference between control and experimental rats in the rate of calcification as measured by ⁴⁵Ca uptake. These results suggest that dietary deficiency induces significant resorption of ectopic bone without altering mineralization capacity. It is suggested that matrix-induced ectopic bone may be used as a suitable experimental model to study pathophysiology of bone loss under various experimental conditions.     

Correlates of forearm bone mass among women during maximal bone mineralization

The distribution and correlates of bone mass among women ages 20-35 were studied. During young adulthood, bone mass reaches its maximum level and appears to stabilize. Factors that establish the individual's relative position in this plateau period may influence the ultimate expression of bone loss with aging. Mid-distal radial bone mass was measured in a geographically defined population of 86 women in two rural, demographically similar communities in Iowa. The water supplies provided 55 and 375 mg/liter of elemental calcium, generating significantly different mean community dietary calcium intakes of 871 and 1,233 mg/day, respectively. Bone mass was measured by single-beam photon densitometry and correlated with data from physical measurements, medical history, and reported nutritional intake. In evaluating the joint effect of variables in a multiple regression procedure, forearm bone mass was negatively and significantly associated with alcohol consumption (P = 0.0327) and with a first pregnancy prior to age 20 (P = 0.0250). There was a trend for current calcium intake estimated from 24-hr recall to be positively associated with bone mass (P = 0.0816). Because the 24-hr recall is characterized by significant error due to daily variability of an individual's intakes, a more general calcium intake was estimated from food frequency. Women whose estimated intake of calcium from food frequency was greater than 800 mg/day, the Recommended Daily Allowance, had significantly greater bone mass than women whose intake was estimated to be less than 800 mg/day (P = 0.0053). No relationship was observed with oral contraceptive use, parity, breastfeeding practices, smoking behavior, or measures of physical activity.