骨髓活检对原发灶不明的骨髓转移瘤的诊断价值  

Diagnostic value of bone marrow biopsy for bone marrow metastatic tumor with unknown primary tumor site

作　　者：吴颖[1] 姚丽青[1] 陈捷[1] 田红[1] 

机构地区：[1]南京军区福州总医院血液科,福建福州350025

出　　处：《南方医科大学学报》2010年第5期1069-1071,共3页Journal of Southern Medical University

基　　金：南京军区"十一五"科研计划项目(06MA143)

摘　　要：目的探讨骨髓活检对于原发灶不明的骨髓转移瘤的诊断价值。方法对38例经骨髓病理形态学观察确诊为骨髓转移瘤患者(原发灶不明)的骨髓活检标本进行免疫组化标记。结果所有骨髓标本骨小梁之间均可见肿瘤细胞浸润,其中诊断低分化腺癌20例,粘液腺癌6例,粘液(印戒)细胞癌6例,低分化鳞状细胞癌4例,恶性黑色素瘤2例。选择适当的免疫组化标记可有效帮助判断转移瘤原发灶。38例均进一步查明了原发瘤的部位,其中胃癌12例,乳腺癌10例,前列腺癌8例,肺癌4例,背部和左足背恶性黑色素瘤各1例,鼻咽癌2例。结论对于原发灶不明的骨髓转移瘤患者,选择适当的免疫组化标记可有效帮助判断转移瘤原发灶,在诊断中起关键作用。Objective To explore the diagnostic value of bone marrow biopsy for bone marrow metastatic tumor with unknown primary tumor site. Methods Thirty-eight cases of metastatic bone marrow tumors were diagnosed by light microscopy, and the bone marrow samples from these cases with unknown primary tumor sites were examined by immunohistochemistry. Results In all the cases, the bone marrow was infiltrated by tumor cells between the bone trabecula. Twenty patients were identified to have poorly differentiated adenocarcinomas, 6 had mucinous adenocarcinomas, 6 had mucinous carcinomas, 4 had poorly differentiated squamous cell carcinomas, and 2 had melanoma. Immunohistochemistry identified the primary tumor sites in these cases, including 12 stomach cancers, 10 breast cancers, 8 prostate cancers, 4 lung cancers, 1 dorsal melanoma, 1 left foot melanoma, and 2 nasopharyngeal cancers. Conclusion Proper immunohistochemistry can help determine the primary tumor sites in patients with metastatic bone marrow tumor with unknown primary tumor sites.

关 键 词：骨髓 活组织检查 骨髓转移瘤 

分 类 号：R733.3[医药卫生—肿瘤]