骨髓增生异常综合征76例的细胞形态学特点分析

目的探讨骨髓增生异常综合征(MDS)患者的骨髓细胞形态学特点。方法用吉姆萨染色法对骨髓增生异常综合征(MDS)患者进行骨髓细胞形态染色,并在光学显微镜下观察分析。结果通过对76例MDS患者骨髓细胞形态的观察分析发现,68例MDS患者骨髓增生程度在活跃和明显活跃之间,MDS粒系异常以P-H细胞(21例,28%)和中粒以下部分细胞质内颗粒减少(20例,26%)最常见;红系异常以老核幼质(34例,45%)、嗜多染(34例,45%)和中空区偏大(29例,38%)最常见;巨核系异常主要以小巨核(14例,18%)改变为主。结论 MDS的诊断主要依靠骨髓的病态造血,但是有病态造血不一定就是MDS,还需结合细胞遗传学、骨髓活检等实验室检查。此外,还要排除其他疾病引起的病态造血,要注意鉴别诊断。

Cytomorphology of myelodysplastic syndrome: an analysis of 76 cases

Objective To investigate the features of bone marrow cytomorphology in patients with myelodysplatie syndromes （MDS）. Methods Bone marrow cell morphology among patients with myelodysplastic syndrome （MDS） was studied with Giemsa staining under light microscope. Results Cytomorphological study among 76 cases of MDS showed hyperplasia to extreme hyperplasia of bone marrow in 68 cases. In these patients, abnormalities in myelocytic series were featured by presence of P-H myeloid cells （21 cases, 28%） and reduced intracytoplamsic granules of neu- trophils （20 eases, 26%）; abnormalities in erythrocytic series by old nuclei and immature cytoplasm （34 cases, 45%）, polychromatie staining （34 cases, 45%）, and oversized hollow area （29 cases, 38%）; and abnormalities in megakaryocyt- ic series by small megakaryocytes （14 cases, i8%）. Conclusion Diagnosis of MDS depends on but is not limited to the presence of bone marrow dyshaematopoiesis, and may also necessitate laboratory findings in relation to cytogenetics and bone marrow biopsy. In addition, differential diagnosis against dyshaematopoiesis caused by other etiologies should be noted.