急性骨髓性白血病に見られる骨髓巨核球の病的變化
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概要
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Occasionally in myeloid leucaemia, there is an increase rather than a decreas in megacaryocytes counts in bone marrow.To the qualitative or more exactly quantitative changes of megacaryocytes, however, little attention has been paid in the literature, especially in acute forms. This paper deals with the appearance of megacaryocytes as found in acute and chronic myelogenous leucaemias.The materials of the present study contain 50 cases of acute myelosis, 16 cases of chronic myelosis and 62 cases of miscellaneous disorders. The number of megacaryocytes contained in 1 cmm. was indirectly enumerated using our own formula from average counting of them in 1cm2 area of bone marrow smears under the low power microscopic magnification. The cells were then examined under the oil immersion objective for structural details. The maturation and the platelets-forming activity of the cells were determined by performing a differential count after the classification of Rohr and also of De La Fuente.In most cases of acute myelosis, the megacaryocytes decreased in number and only 2 cases showed moderate increase of number of the cells in bone marrow. Using the Rohrs classification, the megacaryocytic reaction in 50 cases of acute myelosis were classified into three distinct groups. The first is characterized by a marked inhibition of platelet-forming with some changes in the process of maturation. The number of megacaryocytes in this group is sometimes increased and the immature forms of these cells are frequently larger than normal and show some toxic changes. The second is characterized by a rapid multiplication of cells and an elevation of platelet-formation. The size of megacaryocytes is smaller than normal iu every developmental stage and the nuclei of these cells show frequently small, oval shaped, pyknotic particles. The third show o normal or low total number of the cells, without marked changes in the process of maturation and platelet-formation. Of 50 cases, 4 cases were included in group II and other 11 cases were differentiated in group. I.Although the quantitative and structural changes of megacaryocytes in the patients of group II or I were considered as some specific changes of leukemic proliferating cells, it will be necessary some further detailed observations to conclude this.
- 社団法人 日本内科学会の論文