Search

To explore the diagnostic value of bone marrow cell morphology combined with immunohistochemistry in patients with primary bone marrow lymphoma.The clinical data of 23 patients with primary bone marrow lymphoma diagnosed in the First Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2019 were collected. The characteristics of bone marrow aspiration, bone marrow biopsy and immunohistochemistry results were analyzed retrospectively, and the diagnostic value of bone marrow cell morphology combined with immunohistochemistry in primary bone marrow lymphoma were clarified.Most of primary bone marrow lymphoma was B-cell lymphoma, among which diffuse large B-cell lymphoma was the most common pathological type. Typical lymphoma cells could be found in all the patients. 78.26% of the patients could be diagnosed as lymphoma with pathological type, while 91.30% were diagnosed as lymphoma through combined with the bone marrow immunohistochemistry.Bone marrow cell morphology combined with immunohistochemistry shows very important diagnostic value in patients with primary bone marrow lymphoma.骨髓细胞形态学联合原位免疫组化在原发骨髓淋巴瘤患者中的诊断价值.探讨骨髓细胞形态学联合原位免疫组化在原发骨髓淋巴瘤患者中的诊断价值。.收集西安交通大学医学院第一附属医院2010年1月- 2019年12月23例确诊的原发骨髓淋巴瘤患者的临床资料，回顾性分析骨髓细胞形态学、原位免疫组化和免疫分型等的特点，明确骨髓细胞形态学联合原位免疫组化在原发骨髓淋巴瘤中的诊断价值。.原发骨髓淋巴瘤以B细胞淋巴瘤为主，其中弥漫大B细胞淋巴瘤为最常见的病理类型；所有患者骨髓均可见典型的淋巴瘤细胞，联合原位免疫组化78.26%的患者能够被诊断为原发骨髓淋巴瘤，91.30%的患者确诊为淋巴瘤。.骨髓细胞形态学联合原位免疫组化在原发骨髓淋巴瘤患者中具有重要诊断价值。.

To investigate the clinical significance of bone marrow unclassifiable cells in diagnosis of fever of unknown origin(FUO).The clinical data of 60 patients with FUO admitted in the first affiliated hospital of Xi'an Jiaotong university from June 2014 to May 2016 were collected, and 60 patients with FUO were divided into 2 group: group A(30 cases) in which the unclassifiable cells in bone marrow were observed by bone marrow examination, and group B(30 cases) in which the unclassifiable cells in bone marrow not were found by bone marrow examination. The clinical characteristics, bone marrow features, immunophenotypes of bone marrow cells and prognosis of patients in 2 groups were analyzed retrospectively.Out of 30 patients in group A, 18 were diagnosed as malignant tumors including 12 cases of lymphoma, while out of 30 patients in group B, 5 cases were diagnosed as malignant tumor, including 3 cases of lymphoma. For the patients with non-tumor diseases, the bone marrow unclassifiable cells disappeared after the patients condition was improved.The bone marrow examination including the smear and biopsy shonld be performed routinely for the patients with FUO. If the unclassifiable cells are observed morphologically in bone marrow of patients with FUO, the disease of patients should be considered as malignant tumor, especially, lymphoma.骨髓不明分类细胞在发热待查诊断中的意义.探讨骨髓不明分类细胞在发热待查患者诊断中的临床意义.收集2014 年 6月至 2016 年 5 月西安交通大学第一附属医院收治的60例发热待查患者的临床资料，将患者分为2组：骨髓检查可见不明分类细胞组（30例）和骨髓检查未见不明分类细胞组（30例），并回顾性分析2组患者的临床表现、骨髓特征、骨髓细胞免疫分型特点及预后。.骨髓可见不明分类细胞组的患者中18例确诊为恶性肿瘤，其中12例为淋巴瘤；骨髓未见不明分类细胞组患者中5例确诊为恶性肿瘤，其中3例为淋巴瘤。非肿瘤性疾病患者在病情好转后复查骨髓，不明分类细胞消失。.发热待查患者应常规行骨髓检查。若形态学可见不明分类细胞的发热待查患者应考虑患恶性肿瘤，尤其是淋巴瘤。.

To explore the morphological characteristics of bone marrow cells of multiple myeloma with non-bone-related extramedullary disease and thier clinical significance.Bone marrow smears, peripheral blood smears and bone marrow biopsy sections as well as thier examination results of 20 cases of multiple myloma with non-bone-related extramedullary disease were collected at initial diagnosis in First Affiliated Hospital of Xi'an Jiaotong University from March 2013 to March 2016, and morphological characterisistes of bone marrow cells were analysed in combination with clinical data.The morphology of plasma cells in 20 patients showed 2 cytologic subtypes: primitive cell type (16 cases) and pleomorphic type (4 cases). Immature plasma cells were found in the 5 patients' peripheral blood smear, accounting for about 1%-4% of the number of peripheral blood cells. In bone marrow tissue, plasma cells hyperproliferated with nodular and packed type, and secondary myelofibrosis counted for 12 cases (60%). 13 MM patients whose non-bone-related extramedullary disease occurred during therapy were divided into 2 groups according to the marrow fibrosis density. The median time from diagnosis of MM to extramedullary lesions resulting from fibrosis 0-1 grade and 2-3 grade was 23.7±3.7 months and 10.5±3.2 months ahead of the former(P=0.025).Bone marrow plasma cell morphology of multiple myeloma with non-bone-related extramedullary disease at the initial diagnosis is mostly immature type, and plasma cells proliferate with nodular and packed type and accompanied by different degree of fibrosis. The degree of myelofibrosis indirectly reflects the degree of proliferation and malignancy of the bone marrow plasma cells, which maybe possess some value in predicting extramedullary disease in the early stages of the MM.

To explore the characteristics and diagnostic values of bone marrow cell morphology and immunophenotyping in lymphoma cell leukemia patients.Data of the bone marrow cell morphology and immunophenotyping of 35 patients with lymphoma cell leukemia admitted from January 2012 to January 2017 were analyzed retrospectively, and the value of bone marrow cell morphology and immunophenotype in the diagnosis of lymphoma cell leukemia was evaluated.Bone marrow cell morphological examination showed the typical lymphoma cells in all the patients. The expression of differentiation antigens in lymphoma cell leukemia was consistent with that of original pathological diagnosis. In T-cell lymphoma cell leukemia, the expression of CD7, CD3, CD2, CD5, CD11b, CD34, and HLA-DR were present predominantly, among them the CD7 was the most sensitive antigen and its positive expression rate was 69.2%. In B-cell lymphoma cell leukemia, the expression of CD19, CD20, CD22, CD79a, Skappa, and early antigen HLA-DR were observed predominantly, among them the positive expression rate of CD19 was the highest (89.5%). Out of 35 cases, 28 cases showed that the percentage of lymphoma cells on bone marrow smears was consistent with that of bone marrow immunophenotyping, and 7 cases showed that the percentage of lymphoma cells between bone marrow smears and immunophenotyping differed by more than 1.5-fold.Bone marrow slides combined with immunophenotyping may be helpful for judging lymphoma cell marrow invasion and making early diagnosis of lymphoma cell leukemia.

To investigate the genotype distribution of hemoglobinopathy in Chinese Jiangsu population.A total of 4115 samples were screened for hemaglobinopathy by using MCV combined with erythrocyte fragility tests and HPLC. Thalassemia genotypes were identified by Gap-PCR and Recerse Dot blot. PCR-DNA sequencing and PCR-elecrophoresis were used as supplement of PCR-RBD and for identifying the mutants of globin gene of abnormal hemoglobin.The positive screening rate was 6.10% (251/4115) in Chinese Jiangsu population, 232 cases received thalassemia genotype diagnosis and from them 195 people were positive. In all positive ones, α-thalassemia, β-thalassemia, α-thalassemia combined with β-thalassemia, SEA-HPFH and SEA-HPFH combined with β-thalassemia were found respectively to be 31.28% (61/232), 66.15% (129/232), 1.54% (3/232), 0.43% (1/232) and 0.43% (1/232) of patients. The majority genotype of α-thalassemia was - - (SEA) and IVS-II-654 was the main genotype of β-thalassemia, 11 cases of abnormal hemoglobin were found, including 3 cases of Hb E, 1 Hb Kenitra, 1 Hb Seattle, 1 Hb Saitama, 1 Hb Bushwick, 1 Hb Koln and 1 Hb M-Milwaukee-2.The main hemoglobinpathy is thalassemia in Chinese Jiangsu province and the HPLC play an important role in screening hemoglobinpathy. There is reference value of this study for genetic counseling and prenatal diagnosis.

To explore the value of bone marrow smear and biopsy simultaneously applied to diagnosis of multiple myloma (MM).Clinical data of 30 cases of multiple myloma were collected from our hospital in the year 2014 and analyzed retrospectively, and the results of the bone marrow smear and the simultaneous bone marrow biopsy were compared.Hyperplasia levels in bone marrow biopsy was significantly higher than that in bone marrow smears, and the active and highly active hyperplasia of nucleated cells were observed in all the bone marrow biopsies; the myeloma cells showed a focal or diffuse distribution, the binuclear or polynuclear myeloma cells were observed in 22 patients (73%), but the detection rate of abnormal myeloma cells was 40% in bone marrow smear (P0.05). There was mild to moderate hyperplasia of fibrous tissue in bone marrow biopsy, and the hyperplasia degeree of fibrous tissue strongly positively correlated with the myeloma cell ratio (r = 0.412).The bone marrow smear and aspiration biopsy can complement each other so as to reduce the misdiagnosis rate, therefore contributes to the early diaglosis and treatment.

To investigate the pathological characteristics of bone marrow in non-Hodgkin's lymphoma(NHL) patients with secondary myelofibrosis and their relationship with disease prognosis.The pathological characteristics of bone marrow in 14 NHL patients with secondary myelofibrosis and 30 NHL patients without secondary myelofibrosis received from January 2012 to December 2013 in Department of Hematology, the First Affiliated Hospital Xi'an Jiaotong University Medical School were analysed, and overall survival and progress-free survival rates of NHL patients with and without secondary myelofibrosis were analyzed and compared.14 cases of NHL with secondary myelofibrosis including 9 cases of lymphoma cell leukemia were all at stage IV and had hyperplasia of bone marrow fibrous tissue, the Gomori staining were all positive. When the lymphoma cells in bone marrow decreased or negative, their Gomori staining were negative. If the disease relapsed, the Gomori staining became positive again. There were 30 cases of NHL at stage IV wihtout secondary myelofibrosis. The overall survival rates and progression-free survival rates at 1,3,5 years in these patients were 100%, 93.1%, 57.6% and 100%, 92.6%,52.6% respectively. The overall survival rates and progression-free survival rates at 1,3,5 years in 14 NHL patients with secondary myelofibrosis were 92.9%,81.3%, 48.8% and was 71.8%, 62.3%, 47.9%, respectively.NHL patients with secondary myelofibrosis are almost at stage IV, especially in the patients with lymphoma cell leukemia. They had different degree of hyperplasia of bone marrow fibrous tissue, and the myelofibrosis would be reduced or disappeared when the disease in remission. The overall and progression -free survival rates decrease in NHL patients with secondary myelofibrosis, compared with patients without secondary myelofibrosis. Secondary myelofibrosis is one of the indicators of poor prognosis.

This study was to evaluate the differential diagnostic value of serum Hepcidin in elderly patients with iron deficiency anemia (IDA)and anemia of chronic disease (ACD).The group of IDA consisted of 28 elderly patients, and the group of ACD consisted of 21 elderly patients, the control group included 25 healthy elderly people. Hepcidin was measured by ELISA; WBC,RBC counts were assayed by haematology analyzer; the serum ferritin level was measured by using radioimmunoassay; C-reaction protein(CRP) and serum iron levels were assayed by a biochemical analyzer.Hepcidin level between the three groups was significantly different (P0.01); serum ferritin,WBC and CRP levels in ACD patients were significantly higher than that in IDA patients (P0.01); according to the receivers operating characteristic (ROC) curve, the best threshold in diagnosis of IDA was 93.31 µg/L with the sensitivity of 88% and the specificity of 89%; the best threshold diagnosis of ACD was 130.05 µg/L with the sensitivity of 72% and the specificity of 96%.serum Hepcidin has a certain value in the differential diagnosis of IDA and ACD in elderly patients.

This study was purpose to investigate the cytologic features of bone marrow (BM) and peripheral blood (PB) in hyperleukocytic acute leukemia (HAL) and their clinical significance in accordance with high leukocyte count as poor prognostic factor for acute leukemia. The smears of BM and PB were collected from 68 out-patients and inpatients including 28 cases of HLA and 40 cases of non HAL (NHAL) in our hospital since 2009. The proliferation degree, morphology and abnormal appearance in each cell lineage were observed with HE, POX, PAS, NSE+ NaF staining for BM mears and HE staining for PB smears by means of optical microscope. The final diagnosis was made by cellular chemical staining results, then the counting and classification were performed in 200 nucleated cells to calculate the percentage of each cell lineage, the myeloid/erythroid ratio and so on. The BP smears were observed with the same methods, the counting and classification of 100 nucleated cells were performed to calculate a variety of nucleated cell percentage. The resulted data were analyzed by the SPSS 12.0 statistical software, the difference of proliferation degree and ratio of each cell lineage in BM smears were compared, the relationship of morphological features of PB smears with BM smears was analyzed. The results showed that obvious or extreme active proliferation of nucleated cells was observed in HAL and NHAL groups, but the myeloproliferation in HAL group was more active than that in NHAL group (P0.05). The erythrocyte and megakaryocyte lineages were suppressed in both groups, while the HAL group showed a lower proportion of erythrocyte and megakaryocyte lineages in BM as compared with NHAL group (P0.05). The hemoglobin and platelet levels in PB of HAL group were obviously lower than those in PB of NHAL group (P0.05). The leukemia cells could be seen in PB smears of NHAL, but the proportion of leukemia cells in NHAL group was smaller than that in HAL group (P0.05). The leukocyte count in PB of HAL group strongly positively correlated with the proliferation degree of leukemia cells in BM of HAL group (r = 0.422). It is concluded that the significant difference of proliferation degree, cell levels and blast ratio in BM and PB exists in HAL and NHAL groups, moreover the leukemia cells ratio, leukocyte, hemoglobin and platelet levels in PB of HAL all show characteristic changes. Therefore the contrast analysis of characteristic changes from laboratorial detection contributes to grasp the regular pattern of HAL, meanwhile has an important value for guiding correct diagnosis of acute leukemia and choosing suitable treatment options.

Nuclear factor κB (NF-κB), including RelA, RelB, c-Rel, NF-κB1, and NF-κB2, plays a crucial role in immune response, inflammatory reaction, tumorigenesis, and development of peripheral lymphoid organs and lymphocytes. There are two NF-κB activation pathways: canonical pathway (classical pathway) and noncanonical pathway (alternative pathway). Previous studies focused on the effects of the canonical NF-κB pathway (mainly p50-RelA) in hematological malignancies. Recently, the noncanonical NF-κB pathway (mainly p52-RelB) is gradually taken importance in pathogenesis of hematological malignancies. Understanding the relations of the noncanonical pathway with hematological malignancies would provide a new therapeutic approach for these diseases. This review focuses on the noncanonical NF-κB signaling transduction pathway and its relation to hematologic malignancies.