ID | 53025 |
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フルテキストURL | |
著者 |
Ota, Seisuke
Department of Internal Medicine, Himeji St. Maryʼs Hospital
Hiramatsu, Yasushi
Department of Hematologic Internal Medicine, Himeji Red Cross Hospital
Kondo, Eisei
Department of Hematology and Oncology, Okayama University Hospital
ORCID
Kaken ID
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Kasahara, Akinori
Department of Internal Medicine, Himeji St. Maryʼs Hospital
Takada, Saimon
Department of Internal Medicine, Himeji St. Maryʼs Hospital
Umena, Sachio
Department of Internal Medicine, Himeji St. Maryʼs Hospital
Noguchi, Toshio
Department of Internal Medicine, Himeji St. Maryʼs Hospital
Tanimoto, Mitsune
Department of Hematology and Oncology, Okayama University Hospital
Kaken ID
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Matsumura, Tadashi
Department of Internal Medicine, Himeji St. Maryʼs Hospital
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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 1.4×105/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.
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キーワード | prefibrotic primary myelofibrosis
leukocytosis
anemia
acute gastric mucosal lesion
multiple cerebral hemorrhages
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Amo Type | Case Report
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出版物タイトル |
Acta Medica Okayama
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発行日 | 2014-12
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巻 | 68巻
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号 | 6号
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出版者 | Okayama University Medical School
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開始ページ | 363
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終了ページ | 368
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ISSN | 0386-300X
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NCID | AA00508441
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資料タイプ |
学術雑誌論文
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言語 |
英語
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著作権者 | CopyrightⒸ 2014 by Okayama University Medical School
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論文のバージョン | publisher
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査読 |
有り
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PubMed ID | |
Web of Science KeyUT |