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Bone marrow biopsy

panzenggang 离线

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楼主 发表于 2010-10-12 10:47|举报|关注(0)
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姓    名: ××× 性别:  male 年龄:  77
标本名称:  Bone marrow biopsy
简要病史:  77 years old male, pancytopenia. Bone marrow biopsy
肉眼检查:  
Bone marrow biopsy图1
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Bone marrow biopsy图2
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Bone marrow biopsy图3
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Bone marrow biopsy图4
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×参考诊断
Parvovirus Infection

XLJin8 离线

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1 楼    发表于2010-10-12 16:49:00举报|引用
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1)转移性恶性肿瘤,前列腺癌或恶性黑色素瘤等?

2)低容量性急性白血病/MDS, 需要外周血像、骨髓图片等资料综合考虑。

3)需与巨幼贫鉴别诊断。

4)IHC标记 MPO、PGM1、CD61、Hemoglobin、PSA、PSMA、P501S、AE1/AE3、Cam5.2、HMB-45 等。

谢谢!

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xljin8

wfbjwt 离线

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2 楼    发表于2010-10-12 17:45:00举报|引用
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 骨髓增生程度不高,但见单个散在大细胞,建议标记上皮看看是否为转移癌?
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嫁人就嫁灰太狼,学习要上华夏网。

yourself 离线

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3 楼    发表于2010-10-19 23:07:00举报|引用
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 原幼红细胞核内有淡嗜酸或嗜双色的毛玻璃样均质包涵体,其边核染色质浓聚,首先考虑为微小病毒B19感染(parvovirus B19 infection)

鉴别诊断:巨幼红细胞贫血(megaloblastic anaemia)

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panzenggang 离线

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4 楼    发表于2010-10-28 10:13:00举报|引用
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 http://enjoypath.com/hp/hp-124/hp-124.htm

Final diagnosis:

Parvovirus Infection

  • Parvovirus B19 infection: humans the only known host, mostly self-limited with life-long immunity

  • Virus binds to blood group P antigen receptors

  • Clinical expression: erythema infectiosum in children (Fifth disease), arthralgias and arthritis in adults

  • Effect on hematopoiesis: healthy individuals - transient arrest of erythropoiesis with mild hemoglobin drop; patients with hemolytic disorder - transient aplastic crisis; immunocompromised individuals - pure red cell aplasia

  • Peripheral blood: normochromic normocytic anemia with reticulocytopenia that is resistant to erythropoietin therapy, normal WBC and platelet counts or varying degrees of cytopenia

  • Bone marrow: giant proerythroblasts (lantern cells) with fine megaloblastoid chromatin, loss of normal tinctorial quality, nuclear swelling with dissolution of the nucleus, prominent intranuclear inclusion.. Little maturation occurs beyond the proerythroblast.

  • Virus binds to blood group P antigen receptors

  • Clinical expression: erythema infectiosum in children (Fifth disease), arthralgias and arthritis in adults

  • Effect on hematopoiesis: healthy individuals - transient arrest of erythropoiesis with mild hemoglobin drop; patients with hemolytic disorder - transient aplastic crisis; immunocompromised individuals - pure red cell aplasia

  • Peripheral blood: normochromic normocytic anemia with reticulocytopenia that is resistant to erythropoietin therapy, normal WBC and platelet counts or varying degrees of cytopenia

  • Bone marrow: giant proerythroblasts (lantern cells) with fine megaloblastoid chromatin, loss of normal tinctorial quality, nuclear swelling with dissolution of the nucleus, prominent intranuclear inclusion.. Little maturation occurs beyond the proerythroblast.

Reference: AFIP, Non-Neoplastic Disorders of the Bone Marrow, series 4

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找寻自我2010 离线

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5 楼    发表于2010-10-28 11:16:00举报|引用
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 学习了
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水中央 离线

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6 楼    发表于2010-10-28 13:40:00举报|引用
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 潘老师诊断:细小病毒感染。
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刀锋上的蚂蚁
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