論文

査読有り
2014年12月

Severe Case of Peripheral Leukocytosis Initially Diagnosed as Myelodysplastic Syndrome/Myeloproliferative Neoplasm, Unclassifiable, but Possibly Prefibrotic Primary Myelofibrosis

ACTA MEDICA OKAYAMA
  • Seisuke Ota
  • ,
  • Yasushi Hiramatsu
  • ,
  • Eisei Kondo
  • ,
  • Akinori Kasahara
  • ,
  • Saimon Takada
  • ,
  • Sachio Umena
  • ,
  • Toshio Noguchi
  • ,
  • Mitsune Tanimoto
  • ,
  • Tadashi Matsumura

68
6
開始ページ
363
終了ページ
368
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.18926/AMO/53025
出版者・発行元
OKAYAMA UNIV MED SCHOOL

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 x 10(5)/mu L. 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.

Web of Science ® 被引用回数 : 1

リンク情報
DOI
https://doi.org/10.18926/AMO/53025
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000346882200006&DestApp=WOS_CPL
URL
http://www.scopus.com/inward/record.url?eid=2-s2.0-84920994949&partnerID=MN8TOARS
URL
http://orcid.org/0000-0003-0995-9405

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