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  • 1
    ISSN: 1432-2307
    Keywords: Megakaryocytes ; Chronic myeloproliferative disorders ; Morphometry ; Histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A morphometric evaluation of number and grouping of megakaryocytes (MK) in five different groups of chronic myeloproliferative disorders (CMPD) was performed by counting 60 high power fields equaling approximately 14.28 mm2 of haematopoiesis in each case. Twenty-one up to 29 cases were evaluated for each of five categories of CMPD and one control group; a total of 132 cases of CMPD and 33 control cases were used. The mean number of MK per square millimetre was 15.54±1.53 in chronic myeloid leukaemia of common or granulocytic type (CML.CT), 69.91±5.85 in CML with megakaryocytic increase (CML.MI), 59.59 ±3.27 in polycythaemia vera (P. vera), 59.85±4.59 in primary thrombocythaemia (PTH), 67.58±4.11 in chronic megakaryocytic granulocytic myelosis (CMGM), and 19.7±3.07 in controls. The distinction between free or isolated MK, and between clustered or grouped MK corresponds to the total cell counts of MK in the various groups of CMPD. Clustering of MK was significantly higher in CMGM and PTH compared to other groups, but the difference between them was not statistically significant. Significant differences in the mean number of MK were obtained between controls and CML.CT on the one hand and all other groups of CMPD on the other. The results further support the histological sub-classification of CMPD according to the primary disorders of the Hannover classification (not advanced by sclerosis, fibrosis or excess of blasts, respectively).
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 420 (1992), S. 473-478 
    ISSN: 1432-2307
    Keywords: Histopathology ; Bone marrow ; Megakaryocytes ; Myeloid leukaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A histological study on sequential bone marrow biopsies in patients with chronic myeloid leukaemia (CML) was performed. We wished to answer the question as to whether a different content of megakaryopoiesis in the bone marrow of CML patients has a prognostic significance for the development of myelofibrosis during the course of disease. In addition, the significance of possible changes in the quantity of megakaryopoiesis in this process was assessed. In 186 patients who had no fibre increase at first diagnosis, the rate of subsequent myelofibrosis varied from 19% for the common or granulocytic subtype (CML.CT) to 40% for patients with features of megakaryocytic increase (CML.MI). No significant differences were found either in the rapidity of progression to fibrosis or in the final rate of osteomyelosclerosis. Whereas in CML.MI most patients (75%) showed an increase of fibres only, this was accompanied by an additional increase of megakaryocytes in CML.CT, changing the histological pattern from CML.CT to MI or MP, respectively. The data therefore revealed a correlation between fibre increase and subtyping of CML as suggested by the Hannover classification of chronic myeloproliferative diseases. Subtypes of CML with megakaryocytic increase could be shown to present a “pre-myelofibrotic” stage of disease and may therefore be conceived as a particular pathway of acceleration.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0584
    Keywords: Myeloproliferative disorders ; Megakaryopoiesis ; Histopathology ; Bone marrow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Histologic diagnoses from bone marrow biopsies were analyzed in a total of 1165 patients presenting with thrombocythemic platelet counts at initial examination. Two cut-off points suggested by the Polycythemia Vera Study Group to define thrombocythemia by platelet counts were compared: the former limiting value of 1000×109/l platelets versus the recently proposed value of 600×109/l. The percentage of all nonproliferative disorders was 41% under the lower, dropping to 11% under the high cut-off point. The respective figures for myeloproliferative disorders increased from 49% under the lower to 74% under the high limiting value. Primary thrombocythemia was included in 72% by the lower, and in only 40% by the high limiting value when classified by its histologic pattern in bone marrow biopsy. A striking decrease of platelet counts occurs, related to fiber increase, among each of three main groups of myeloproliferative disorders: in CML with megakaryocytic predominance from 40% down to 25%, in megakaryocytic-granulocytic myelosis (primary, i.e., agnogenic myelofibrosis) from 36.6% to 10%, and in primary thrombocythemia from 72.6% to 28.6% in cases with reticulin sclerosis.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Myelodysplastisches Syndrom ; Knochenmark ; Zytogenetik ; Histopathologie ; Prognose ; Key words Myelodysplastic syndrome ; Bone marrow ; Cytogenetics ; Histopathology ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The value of cytogenetics performed simultaneously with histopathology was evaluated in patients with myelodysplastic syndrome (MDS). Clonal karyotype changes of the bone marrow cells supporting the histological diagnosis were found in 38/69 cases (55 %). The chromosome aberrations, especially complex changes, were significantly correlated to distinct histopathological findings such as atypias of the haematopoietic cell lines and myelosclerosis. Complex karyotype changes were further associated with short survival of the MDS patients. Our results demonstrate that cytogenetic analyses are helpful in supplementing the histopathological diagnoses. Recent developments in molecular cytogenetics even allow the detection of chromosomal aberrations in non-dividing cells from cytological preparations or tissue sections which may become available for routine diagnosis.
    Notes: Zusammenfassung Die Bedeutung simultaner zytogenetischer und histologischer Untersuchungen wurde bei Patienten mit myelodysplastischem Syndrom (MDS) überprüft. Die Ergebnisse zeigen, daß klonale Karyotypveränderungen der Knochenmarkzellen bei 38 der 69 (55 %) analysierten Patienten auftraten und damit häufig eine Absicherung der histologischen Diagnose erlaubten. Die Chromosomenanomalien, insbesondere komplexe Karyotypveränderungen, korrelierten signifikant mit einer Reihe histopathologischer Befunde, darunter Atypien der einzelnen hämatologischen Zellreihen und Myelosklerose. Durch den Nachweis komplexer Karyotypveränderungen war eine unabhängige prognostische Aussage möglich. Damit zeigen unsere Ergebnisse am Beispiel des MDS, daß zytogenetische Analysen eine sinnvolle Ergänzung der histologischen Untersuchung sein können. Darüber hinaus ist durch den Einsatz der molekularen Zytogenetik die Bestimmung von Chromosomenanomalien in zytologischen Ausstrichpräparaten oder Gewebeschnitten möglich, wodurch sich solche Befunde auch für die tägliche Diagnostik verwenden lassen.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Der Pathologe 16 (1995), S. 46-52 
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Anämie ; Histologie ; Erythropoese ; Aplastische Anämie ; Hämolyse ; Key words Anemia ; Histology ; Hemolysis ; Aplastic anemia ; Erythropoiesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A total of 41,553 bone marrow biopsies were collected for the Bone Marrow Registry from January 1989 to June 1994 included 6,366 taken from 5,011 patients referred because of unexplained anemia. An increasing percentage of biopsies submitted for examination are designated anemic: this rose from 7.2 % in 1989 to 18.9 % within the first 6 months of 1994, reflecting an increased need to find the reasons for anemic conditions. Histologically, seven main groups have been found: (1) myelodysplastic syndrome (MDS) accounting for 32 % of all anemia patients seen, (2) infectious anemia (23.5 %), (3) iron deficiency anemia (22.7 %), (4) hemolytic anemias (7.2 %), (5) aplastic anemia (6.8 %), (6) megaloblastic/pernicious anemia (5.0 %), and (7) anemia due to bleeding (3.0 %). These seven groups of anemia can be diagnosed in core biopsies on the basis of their particular histopathology, so that films of bone marrow smears are not always needed.
    Notes: Zusammenfassung Die Auswertung von 6 366 Untersuchungen, die wegen unklarer Anämie im Knochenmarksregister in den Jahren 1989 bis Juni 1994 untersucht worden sind, zeigt eine eindeutige Zunahme des Anteils der Anämien an den Einsendungen: 1989 waren es nur 7,2 %, im ersten Halbjahr 1994 aber 18,9 %, der Durchschnittswert beträgt rund 15 % in den insgesamt 41 553 in dieser Zeit untersuchten Biopsien. Die Zunahme ist v. a. auf die Zahl von Untersuchungen bei den über 50 jährigen zurückzuführen, die 73 % der 5 011 untersuchten Patienten ausmachen. Dies hängt besonders mit dem auf das Alter konzentrierten myelodysplastischen Syndrom zusammen, das mit fast 32 % Anteil die weitaus häufigste Ursache einer Anämie im Register ist. Neben dem myelodysplastischen Syndrom sind die Anämien infolge einer Entzündung oder infolge eines Mangels an Speichereisen im Knochenmarksregister mit 23,5 bzw. 22,7 % Anteil besonders häufig. Weitere, jedoch mit einem Anteil zwischen 3 und 7,2 % weit weniger bedeutende Ursachen einer Anämie sind in absteigender Häufigkeit die vielschichtige Gruppe der hämolytischen Anämien, die aplastische Anämie sowie die Gruppe der megaloblastären bzw. echten periziösen Anämie und die Anämie bei Blutung. Die einzelnen Anämieformen können durch typische histologische Veränderungen in der Biopsie des Knochenmarks unterschieden werden. Die Histopathologie der 6 wesentlichen Hauptgruppen wird beschrieben.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Der Pathologe 16 (1995), S. 70-74 
    ISSN: 1432-1963
    Keywords: Schlüsselwörter CML ; Histopathologie ; Knochenmark ; Megakaryozyten ; Histiozyten ; Key words CML ; Histopathology ; Bone marrow ; Megakaryocytes ; Histiocytes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Histopathology of the bone marrow of diagnostic biopsies prior to any therapy is described in a total of 412 Ph1-positive patients. Special attention is paid to the distribution of megakaryocytes, increase of fibres and blasts, and occurrence of storing histiocytes of pseudo-Gaucher type. Megakaryocytes were significantly increased in 31.6 % of diagnostic biopsies, myelofibrosis was found in 15.8 %, significant increase of blasts in 2.4 %. Pseudo-Gaucher cells were detected in 57.8 % of a total of 412 biopsies. These histiological features are considered as an indication of the progress of the disease. A semiquantitative specification of CML by this criteria is described which can be performed rather reliably and defines the stage of CML at diagnosis prior to substantial treatment.
    Notes: Zusammenfassung Die Histopathologie der chronischen myeloischen Leukämie (CML) wird aus den diagnostischen Biopsien des Knochenmarks von 412 Philadelphia-positiven Patienten beschrieben. Besonders berücksichtigt wird die Verteilung der Megakaryozyten, die Vermehrung von Fasern, von Blasten und von speichernden Histiozyten, nämlich der Pseudo-Gaucher-Zellen. Die Megakaryozyten waren eindeutig vermehrt bei 31,6 % der Patienten am Tag der Diagnose. Eine erkennbare Myelofibrose wiesen 15,8 % auf, eine deutliche Blastenvermehrung 2,4 % der Patienten. Speichernde Histiozyten vom Typ der Pseudo-Gaucher-Zellen zeigten 57,8 % im Knochenmark. Die Veränderungen werden als morphologische Kriterien der fortschreitenden Erkrankung interpretiert. Es bietet sich an, die CML semiquantitativ einzuteilen, was einfach und sicher durchgeführt werden kann. Damit wird die Erkrankung aus der Knochenmarkbiopsie heraus besser verständlich und für Verlaufsuntersuchungen definiert.
    Type of Medium: Electronic Resource
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