[细胞减少症的骨髓组织学 :对血液学鉴别诊断的贡献]。

Pathologie (Heidelberg, Germany) Pub Date : 2024-03-01 Epub Date: 2024-02-21 DOI:10.1007/s00292-024-01302-z
Hans Kreipe
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引用次数: 0

摘要

除了对涂片进行显微镜评估、流式细胞分析、染色体和分子研究外,骨髓活检组织学分析(BMbx)也是血液学中细胞减少症多参数诊断的重要组成部分。与组织病理学的其他领域相比,骨髓活检的正确解读更需要与这些进一步研究的结果和其他临床发现相关联。小红细胞性贫血、正常红细胞性贫血和大红细胞性贫血、孤立的粒细胞减少症和血栓性血小板减少症以及全血细胞减少症是常见病和多发病。关于病因,必须区分反应性病因和肿瘤性病因。反应性细胞减少症的病因包括底物缺乏、翻转和丢失增强以及炎症过程。肿瘤性疾病(骨髓增生性肿瘤除外)通常表现为全血细胞减少,包括骨髓增生异常综合征(MDS)、急性髓性白血病(AML)和淋巴瘤。
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[Bone marrow histology of cytopenias : Contribution to hematological differential diagnosis].

Besides microscopic evaluation of smears, flow cytometric analysis, chromosomal and molecular studies, histological analysis of bone marrow biopsies (BMbx) is an important component of multiparameter diagnostics of cytopenias in hematology. More than in other fields of histopathology, correct interpretation of BMbx requires correlation with the results of these further studies and other clinical findings. Microcytic, normocytic and macrocytic anemia, isolated granulocytopenia and thromobocytopenia as well as pancytopenia represent frequent and recurrent diseases. With regard to aetiology, reactive and neoplastic causes must be differentiated. Reactive causes of cytopenia include substrate deficiencies, enhanced turn over and loss, and inflammatory processes. Neoplastic disorders with the exception of myeloproliferative neoplasms generally manifest as cytopenia and comprise myelodysplastic syndromes (MDS), acute myeloid leukemia (AML) and lymphoma.

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