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目的:研究血液病患者骨髓间质超微病理特点。方法:透射电子显微镜观察13例血液病患者骨髓活检组织。结果:所有患者髓窦、造血岛和血管关系紊乱,成纤维细胞增多;部分患者出现成纤维细胞活化和肌成纤维细胞转化,与胶原积聚和不定形细胞外基质增多相关。白血病患者骨髓同时存在白血病细胞增生和破坏;骨髓增生异常综合征粒、红细胞凋亡显著,嗜酸粒细胞增多;真性红细胞增多症骨髓晚幼红裸核增多,巨噬细胞吞噬活跃;原发性骨髓纤维化骨髓嗜酸粒细胞和巨核细胞释放大量致密颗粒。结论:血液病患者骨髓结构紊乱,成纤维细胞不同程度增生,成纤维细胞活化和肌成纤维细胞转化与细胞外基质积聚相关;纤维细胞的多克隆增生和纤维化可能继发于大量血细胞破坏和活性物质释放引起的炎性反应。
Objective: To study the ultrastructural features of bone marrow in patients with hematological diseases. Methods: Thirteen cases of bone marrow biopsy were observed by transmission electron microscopy. Results: All the patients had disorganized relationship between the medullary sinusoid, hematopoietic island and blood vessel, and increased fibroblasts. Some patients showed fibroblast activation and myofibroblast transformation, which were related to the accumulation of collagen and the extracellular extracellular matrix. Leukemia patients with bone marrow proliferation and destruction of both leukemia cells; myelodysplastic syndrome particles, significant red blood cell apoptosis, eosinophilia; polycythemia vera increased bone marrow late red nude, macrophage phagocytosis; primary Myelofibrosis Bone marrow eosinophils and megakaryocytes release a large number of dense particles. CONCLUSIONS: Hematological diseases are characterized by disorder of bone marrow structure, proliferation of fibroblasts to varying degrees, activation of fibroblasts and transformation of myofibroblasts with accumulation of extracellular matrix. Polyclonal proliferation and fibrosis of fibroblasts may be secondary to massive destruction of blood cells and Inflammatory reaction caused by release of active substance.