JaLCDOI 10.18926/AMO/53025
フルテキストURL 68_6_363.pdf
著者 Ota, Seisuke| Hiramatsu, Yasushi| Kondo, Eisei| Kasahara, Akinori| Takada, Saimon| Umena, Sachio| Noguchi, Toshio| Tanimoto, Mitsune| Matsumura, Tadashi|
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 1.4×10<sup>5</sup>/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
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 25519030
Web of Sience KeyUT 000346882200006