MDSの骨髄像

Cytomorphology of bone marrow in MDS

MDSの診断は，今なお細胞形態に依拠している．最適な骨髄塗抹染色標本を作製し，芽球と形態学的異形成(dysplasia)を同定・評価することが最も大切である．芽球は顆粒を有しない芽球(agranular blast)と顆粒を有する芽球(granulated blast)に大別され，前骨髄球との鑑別はゴルジ野の有無による．各血球系の異形成を点数化してMDS診断に応用すると診断確度に有用かもしれない．異形成の種類とMDS病型には，5q-症候群における単核巨核球を除き関連性はない．

Diagnosis of MDS has been based on morphological findings.　It is most important to identify and estimate blasts and morphological dysplasia in the bone marrow smears stained with high quality.　Blasts consist of an agranular type having no azure granules in the cytoplasm, and granulated type having granules, and promyelocytes can be discriminated from the blasts by having a clear area of the Golgi field.　The scoring system of several kinds of dysplasia may be useful for the accuracy of MDS diagnosis.　The relationship between the kind of dysplasia and the MDS subtypes has not been found without mononuclear megakaryocytes in 5q- syndrome.