骨髓片辅导PPT课件.ppt

1,血涂片及骨髓细胞学检查,.,2,血涂片,.,3,NormalTargetpyropoiklocyteEchinocyteTeardropsSpherocyteElliptocyteFragementsBitecellSicklecellSicklecellPseudo-morphosim,4,5,6,7,8,9,Microscopyexaminationofbonemarrowcells,Lowpowerlens:Proliferativedegree,Extremeactiveobviousactivehypoplasiaextremehypoplasia1:110:120:150:1300:1,10,1、缺铁性贫血irondefiencyanemia,小细胞：体积小低色素：红细胞中心浅染区扩大，面包圈变铁丝圈铁染色：内外铁均减少,11,IDA,NORMAL,Anisocytosis红细胞大小不等,12,13,2、Megaloblasticanemia,Macrocyticanemia增生性贫血巨幼粒、红细胞核浆发育不同步骨髓内铁不少,14,Perniciousanemia,15,3、Hemolyticanemia,Normocyticnormalchromaticanemia,嗜多染细胞polychromaticerythrocyte畸形、破碎红细胞，红细胞可以大小不等增生性贫血,16,17,G6PDhemolyticanemia,18,AIHA,19,4、再生障碍性贫血（AplasticAnemiaAA）,正细胞正色素性贫血骨髓增生：/级，一片荒凉粒、红两系均明显减少很难看见早期幼稚细胞淋巴细胞相对，可达80%。,20,AA-BM,21,22,5、急性白血病急性髓性细胞白血病（AcutemyelocyticleukemiaAML）急性淋巴细胞白血病(AcutelymphocyticleukemiaALL）,23,AML-M2,ALL-L2,24,APL细胞形态特点：核扭曲变形多颗粒内外浆伪足AuresbodyPOX强阳性,25,26,27,28,29,30,慢性髓细胞白血病的特征,血象与骨髓象类似。白细胞数量异常增多。100-1000109/l，血片中可发现中、晚幼粒细胞，嗜酸、嗜碱粒细胞易见到。,31,CML-CP,32,33,类白血病反应,34,CLL,外周血中白细胞10109/L，淋巴细胞绝对值5109/L，骨髓中淋巴细胞40%，成熟小淋巴细胞,35,36,37,Multiplemyeloma,血象：正细胞正色素的贫血血沉增快，红细胞呈缗钱样排列ROULEAUformation骨髓象：出现骨髓瘤细胞，（10%）灶性分布，瘤细胞容易在涂片时被推至尾部,38,39,40,41,42,骨髓增生异综合症（MyelodysplasticsyndromeMDS）,43,44,45,46,Idiopathicthrombocytopenicpurpura,骨髓特点：增生活跃，粒红两系正常，巨核细胞增多或正常，有成熟障碍，血小板减少血象特点：粒红两系正常，血小板减少,47,Megakaryocyteandmegararyoblast,48,49,诊断某些代谢障碍性疾病。如：Gaucher病、Niemann-pick。,高雪氏病葡糖脑苷脂沉积病,尼曼匹克病鞘磷脂沉积病,50,诊断某些原虫感染。如：疟疾、黑热病等。,51,52,诊断原发性及转移癌。如：肺癌、胃癌、前列腺癌