血液学の話題：血液学の問題点

Topics in Hematology: Hematology Problem

　51歳，男性，発熱，不快感，右胸膜炎様胸痛にて来院．これらの症状はウイルス感染症を思わせた．第1回目入院（3日間）で，肋骨縁下7cmに及ぶ脾臓の腫大が発見され，レントゲン検査で右肺中葉の浸潤がみられた．

　血液検査：Hb 10.5gm/dl，Ht 0.33l/l，網赤血球6.4％，血小板160.6×10⁹/l，WBC 8.6×10⁹/l．血液像：赤血球　正常，血小板1油浸視野に4個，白血球分類：好中球杆状球2％，分葉球11％，リンパ球27％，その他26％．

A 51-year-old man was hospitalized because of fever, malaise, and right pleuritic chest pain ; these symptoms were suggestive of a viral infection. On first admission (which lasted for three days) he was found to have an enlarged spleen 7 cm below the costal margin. X-ray examination showed a right middle lobe infiltrate. Blood studies revealed : Blood Smear : Hemoglobin 10.5gm/dl RBCs-essentially normal Hematocrit 0.33l/l Platelets-4/oil immersion field Reticulocytes 6.4 % WBC differential : Platelets 160.0×10⁹/l Neutrophilic band cells 2 % WBC 8.6×10⁹/l Neutrophilic segmented cells 11 % Lymphocytes 27 % Other cells 56 %