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ID 53025
JaLCDOI
フルテキストURL
著者
Ota, Seisuke Department of Internal Medicine, Himeji St. Maryʼs Hospital
Hiramatsu, Yasushi Department of Hematologic Internal Medicine, Himeji Red Cross Hospital
Kondo, Eisei Department of Hematology and Oncology, Okayama University Hospital
Kasahara, Akinori Department of Internal Medicine, Himeji St. Maryʼs Hospital
Takada, Saimon Department of Internal Medicine, Himeji St. Maryʼs Hospital
Umena, Sachio Department of Internal Medicine, Himeji St. Maryʼs Hospital
Noguchi, Toshio Department of Internal Medicine, Himeji St. Maryʼs Hospital
Tanimoto, Mitsune Department of Hematology and Oncology, Okayama University Hospital
Matsumura, Tadashi Department of Internal Medicine, Himeji St. Maryʼs Hospital
抄録
Leukocytosis is occasionally seen in patients with presumptive but undiagnosed myeloproliferative disorders (MPD). A 74-year-old woman was admitted to our hospital for tarry stools, anemia, and marked peripheral leukocytosis of 1.4×105/μL. Gastroenteroscopy revealed an acute gastric and duodenal mucosal lesion that was treated successfully via endoscopic hemoclipping. Bone marrow aspiration revealed marked megakaryocyte proliferation with atypia of naked nuclei and marrow hypercellularity (90% cellularity). A fluorescence in situ hybridization test could not detect the BCR-ABL fusion gene. Bone marrow aspiration later revealed further abnormalities of megakaryocytes. The patient died from cerebral bleeding. The present case fulfilled 2 of the 3 major criteria of primary myelofibrosis according to the World Health Organization 2008 classification:namely, megakaryocytic hyperplasia with hypercellular marrow and granulocytic hyperplasia. However, the megakaryocytic abnormality was not strictly compatible with the criteria. Instead, we considered prefibrotic primary myelofibrosis as a possibility, although myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) was technically the correct diagnosis. The present case shows that MPN diagnosis remains difficult and suggests that other cases of peripheral leukocytosis with diagnosed MDS/MPN-U might include similar findings.
キーワード
prefibrotic primary myelofibrosis
leukocytosis
anemia
acute gastric mucosal lesion
multiple cerebral hemorrhages
Amo Type
Case Report
発行日
2014-12
出版物タイトル
Acta Medica Okayama
68巻
6号
出版者
Okayama University Medical School
開始ページ
363
終了ページ
368
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
著作権者
CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Sience KeyUT