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1 病例介绍患者男,35岁,乏力半年,加重伴劳力性气短10天于1995年2月16日入院.查体:重度贫血貌,颈部和胸前可见数个出血点,左颌下和左腋下可触及数个黄豆至花生米大小淋巴结,质韧,活动,无压痛.肝肋下2cm,质韧,无触痛,脾未及.外周血象:WBC3.1×10~9/L,中性杆状核0、14,中性分叶核0.53,L0.28,M0.03,E0.02;RBC 2.56×10~(12)/L;Hb56g/L;PC78X10~9/L;血片中可见巨大血小板、骨髓穿刺5次干抽,1次骨穿成功报告:骨髓增生明显活跃,原粒0.07,早幼粒0.07,中幼粒0.09,晚幼粒0.14,中性杆状0.07,中住分叶0.04.嗜酸杆状0.01,嗜酸分叶0.002,成熟中性粒细胞可见Pekger畸形;红系增生活跃,部分呈类巨幼样变,核染色质呈粗块网状;巨核细胞7个,血小板少见;淋巴细胞0.008、诊断:MDS-RAEB.3次骨髓活检报告:骨髓纤维组织明显增多,造血组织少并和纤维组织
1 case description Male patient, 35 years old, fatigue for six months, aggravated with labor shortness of breath for 10 days in February 16, 1995 admitted to the hospital Physical examination: severe anemia appearance, neck and chest visible several bleeding points, left submandibular and Left axilla can reach several small beans to peanuts size lymph nodes, quality and toughness, activity, no tenderness .Liver ribs 2cm, quality and toughness, no tenderness, spleen not .Peripheral blood: WBC3.1 × 10 ~ 9 / L , Neutral rod core 0,14, neutral leaf core 0.53, L0.28, M0.03, E0.02; RBC 2.56 × 10-12 / L; Hb56g / L; PC78X10-9 / L; Large blood platelets can be seen in the blood film, bone marrow puncture 5 times dry pumping, a bone wear report: bone marrow hyperplasia was significantly active, 0.07 primordial, promyelocytic 0.07, 0.09 in young, late young 0.14, 0.07 neutral rod , Living in the leaves 0.04. Eosinophilic rod 0.01, eosinophilic leaves 0.002, mature neutrophils Pekger deformity can be seen; erythroid hyperplasia was active, some showed megaloblastic degeneration, nuclear chromatin was coarse reticular; 7 megakaryocytes, rare platelets; lymphocytes 0.008, diagnosis: MDS-RAEB.3 times bone marrow biopsy report: bone marrow fibrosis significantly increased, less hematopoietic tissue and fibrous tissue