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| The Value of Megakaryocyte Morphology in Bone Marrow Biopsy in Differential Diagnosis of Primary Thrombocytosis, Polycythemia Vera and Primary Myelofibrosis |
| BAO Shuzhen, ZHANG Rufeng, MA Fengying, et al |
| Xining First People's Hospital, Qinghai Xining 810000, China |
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Abstract Objective: To analyze the diagnostic value of megakaryocyte morphology in bone marrow biopsy in differentiating primary myelofibrosis, polycythemia vera andprimary thrombocytosis. Methods: The clinical data of 78 patients with primary myelofibrosis (group A), 52 patients with polycythemia vera (group B) and 63 patients with primary thrombocytosis (group C) were collected retrospectively. The differences of blood routine, bone marrow smear cell count, percentage of megakaryocytes and morphological changes in bone marrow biopsy were compared among the three groups. Results: Compared with group A and B, platelet count (PLT) in group C increased significantly (P<0.05); white blood cell count (WBC) in three groups had no significant difference (P>0.05); hemoglobin (Hb) level in group B was significantly higher than that in group A and C, and Hb level in group C was significantly higher than that in group A (P<0.05). There was no significant difference in megakaryocyte count, erythrocyte percentage and granulocyte percentage among the three groups (P>0.05). Compared with group B and C, the percentage of type I and VI megakaryocytes in group A increased significantly (P<0.05); Compared with group A and C, the percentage of type III megakaryocytes in group B increased significantly (P<0.05); Compared with group A and B, the percentage of type IV and V megakaryocytes in group C increased significantly (P<0.05). Conclusion: In bone marrow biopsy, the morphology and percentage of paratrabecular megakaryocytes and nuclear shrinkage megakaryocytes are helpful to differentiate and diagnose primary myelofibrosis. The morphology and percentage of oligophyllotic megakaryocytes are helpful to differentiate and diagnose polycythemia vera. The morphology and percentage of giant multilobular nuclear megakaryocytes are helpful to differentiate and diagnose primary thrombocytosis.
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2019, Vol. 25 
