骨髓肉芽肿病20例临床分析

目的 探讨伴有骨髓肉芽肿病理表现的疾病种类及其临床特征.方法 回顾2001年1月至2007年12月本院骨髓活检的组织病理结果,对其中发现骨髓肉芽肿的临床资料进行分析.结果 5217例次骨髓活检中有20例患者发现骨髓肉芽肿,阳性率为0.38%,年检出率为2.9例/年.最终诊断血行播散型结核病13例占65%、血液肿瘤4例、病毒性肝炎2例以及急性间质性肾炎1例.结论 骨髓肉芽肿是一种少见的病理改变,结核感染、血液系统肿瘤及病毒性肝炎是其最主要的病因.骨髓活检是诊断血行播散型结核病的蕈要手段.

A clinical analysis of 20 cases with bone marrow granulomas

Objective To study the clinical feature and original diseases of bone marrow granulomas. Methods A total of 5217 bone marrow biopsies were retrospecitively analyzed in Peking Union Medical College Hospital from January 2001 to December 2007. Results Bone marrow granulomas were present in 20 cases, representing an incidence of 0.38% in the series and an annual incidence of 2. 9 cases per year. Finally, 13 of these cases (65%) were diagnosed with tuberculosis. Hematological neoplasms and viral hepatitis were found in 4 and 2 cases respectively. Acute interstitial nephritis was diagnosed in one case. Conclusions The finding of a granuloma in a bone marrow biopsy is not common and unspecific.Tuberculosis, hematological neoplasms and viral hepatitis are the most common underlying diseases. Bone marrow biopsy is an important method for the diagnosis of disseminated tuberculosis.