胸腹水を伴った原発性骨髄線維症の２例

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  • Two cases of primary myelofibrosis with pleural effusion and ascitic fluid.

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Two cases of primary myelofibrosis with pleural effusion and ascitic fluie are reported.<BR>Huge cells with abundant, homogeneous to finely reticulated cytoplasm in Papanicolaou-stained smears were observed in the ascitic fluid of case 1. The central portion of the cytoplasm of the huge cells was eosinophilic, and the peripheral portion was basophilic. Multilobulated nuclei were eccentrically located. The nuclear edge was thin, and a finely reticulated chromatin pattern partially accompanied with chromatin clumps was observed. Furthermore, huge cells with coiled nuclei and scanty cytoplasm were also seen. The huge cells were diagnosed as megakaryocytes by May-Giemsa stain. However, it was difficult to differentiate these cells from cancer cells, Reed-Sternberg cells, and other sarcoma cells in Papanicolaou-stained smears.<BR>Many small atypical cells were scattered in the ascitic fluid of case 2. These atypical cells showed scanty cytoplasm in Papanicolaou-stained smears. The nuclei were oval and the nuclear edge was thin. The chromatin pattern of atypical cells was fine and the stainability of the nucleus was increased. These cells were diagnosed as erythroblasts and immature granulocytes by May-Giemsa stain. In Papanicolaou-stained smears, it is important to distinguish hematopoietic cells from malignant lymphoma cells.

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