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目的:分析前列腺胚胎性横纹肌肉瘤(embryonal rhabdomyosarcoma,ERMS)骨髓转移后细胞形态学特点,探讨其作为辅助临床分期和治疗的潜在价值。方法:1例前列腺ERMS患者抽取骨髓,行细胞涂片,采用常规瑞氏染色、过氧化物酶染色、糖原染色,对骨髓中ERMS细胞形态学特征及细胞化学染色结果进行分析。并复习相关文献,结合其临床表现、病理学检查、治疗及国内外研究进展等方面进行讨论。结果:该患者骨髓象示粒、红、巨三系增生明显受抑,瘤细胞占66%,散在或成团分布;胞体大小不一,胞浆量丰富,色深蓝,易见较多空泡,边缘可见瘤状突起;胞核较大,双核及多核可见;核染色质粗糙疏网状,核仁大而明显。细胞化学染色示瘤细胞过氧化物酶染色阴性,糖原染色粗细不等颗粒状阳性。结论:前列腺ERMS通过对患者原发部位病理活检结合相关免疫组化结果可以确诊。当外周血出现至少一系减低或可见幼红、幼粒细胞时应考虑肿瘤骨髓转移的可能,及时行骨髓细胞学检查,细胞形态及化学染色结果符合ERMS细胞特征,从而为临床分期及治疗提供可靠依据。
OBJECTIVE: To analyze the morphological features of bone marrow after embryo rhabdomyosarcoma (ERMS) metastasis, and to explore its potential value as a supplementary clinical staging and treatment. Methods: One patient with ERMS from prostate was selected for bone marrow smear. Morphological characteristics and cytochemical staining of ERMS cells in bone marrow were analyzed by Wright staining, peroxidase staining and glycogen staining. And review the relevant literature, combined with its clinical manifestations, pathological examination, treatment and research progress at home and abroad to discuss. Results: The bone marrow of the patient showed obvious inhibition of the proliferation of the three lines of the granulosa, erythrocyte and giant tumor. The tumor cells accounted for 66% of the total, scattered or in groups. The cytoplasm varied in size, cytoplasm, and dark blue color. , The edge of the tumor can be seen protruding; larger nucleus, dual-core and multi-core visible; nuclear chromatin rough sparse network, large and obvious nucleoli. Cytochemical staining showed tumor cells peroxidase staining negative, glycogen staining ranging from grainy positive particles. Conclusion: Prostate ERMS can be diagnosed by pathological biopsy combined with immunohistochemical results of the primary site of the patient. When the peripheral blood appears at least a series of reduced or visible young red, promyelocytosis should consider the possibility of tumor bone marrow metastasis, timely bone marrow cytology, cell morphology and chemical staining results in line with ERMS cell characteristics for clinical staging and treatment Reliable basis.