骨髓检查完整版本.pptVIP

骨髓检查

(ExaminationofBoneMarrow)Byfrank2145@dxy.cn骨髓组织

(myeloidtissue)网状组织(reticulartissue)基质(stroma)血管系统(bloodvessels)神经(nerves)血细胞(hemocytes)骨髓检查的目的常用于细胞形态学检查(cellmorphology)造血干细胞培养(culturehemopoieticstemcell)细胞遗传学检查(examinationofcytogenetics)病原学检查：(etiology)细菌培养，寄生虫检查，红斑狼疮细胞检查Examinationforbacteria;parasite;andLupuserythematosuscell骨髓细胞形态检查方法

ApproachstoMorphologyofBoneMarrow普通光学显微镜(Lightmicroscope)相差显微镜(phasecontrastmicroscope)荧光显微镜(fluorescencemicroscope)透射及扫描电子显微镜(transmissionandscanningelectronmicroscope)骨髓细胞形态学检查的临床应用确定诊断：各类白血病，恶性组织细胞病，多发性骨髓瘤，再生障碍性贫血，巨幼细胞性贫血；骨髓转移癌，疟原虫，黑热病小体等definitethediagnoses:leukemia,malignanthistiocytosis,multiplemyeloma,aplasticanemia,megaloblasticanemia,cancermetastasistobonemarrow,plasmodium;Leishmaniaetc.辅助诊断：溶血性贫血，血小板减少性紫癜，骨髓增生异常综合症，真性红细胞增多症，原发性骨髓纤维化assistthediagnoses:hemolyticanemia;thrombocytopenia;myelodysplasticsyndroms;polycythemiavera;Myelofibrosis鉴别诊断：不明原因的发热，淋巴结/肝/脾肿大；外周血异形淋巴细胞；类白血病反应；嗜酸性粒细胞增多等differentialdiagnosis:Feverofunknoworigin;Swellingoflymphnodesorliverorspleen;leukemoidreaction;eosinophilia临床应用中应注意的问题对某些局灶性病变可能需多次多部位穿刺如：恶组，骨髓转移癌，慢性再障，骨髓瘤等ExaminationMorethanonetimeoronesiteisneededsometimes:malignanthistiocytosis;cancermetastasistobonemarrow;chronicaplasticanemia;myelomaetc.某些病须结合病理学检查如：骨髓纤维化（Myelofibrosis），某些白血病，骨髓增生异常综合症，再生障碍性贫血pathologicexaminationisneededforthediagnosisofsomedisease:Myelofibrosis;sometypesofleukemia;myelodysplasticsyndroms;aplasticanemia由于凝血因子缺乏有严重出血者应列为禁忌Abstinence:forpatientswhoissufferingseverebleedingduetothedeficiencyofcoagulationfactor血细胞的生成,发育规律及正常形态学特征血细胞发育过程中形态学演变的一般规律血细胞发育过程中形态学演变的一般规律

commonfeaturesofmorphologicchangesduringbloodcellmaturation细胞大小及形态(sizeandshape)：由原始到成熟，胞体由大变小，但巨核细胞相反；早幼粒细胞可比原粒细胞稍大。红系始终呈圆形；