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In chronic lymphocytic leukaemia (CLL) bone marrow trephine biopsy (BMT) is not required for diagnosis but can have a significant prognostic value and can be used for the detection of the minimal residual disease (MRD) and for assessment of the effectiveness of the treatment applied. The aim of the study was to evaluate the morphological changes in bone marrow after treatment with purine nucleoside analogues cladribine and fludarabine. Bone marrow trephine biopsy was taken routinely from 15 patients with CLL. Bone marrow trephine biopsy was performed on every patient before as well as after chemotherapy. The number of cell elements of the marrow (the degree of atrophy), the patterns of bone marrow infiltration, the presence of reticulin and collagen fibres and the disturbances in bone marrow stroma were assessed. The infiltration of bone marrow by neoplastic cells was observed in all the patients before administration of chemotherapy. The infiltration was followed by an increase in the number of reticulin fibres. After the treatment a regression of the reticulin fibres was observed with the lessening of the infiltration. After the treatment the levels of marrow infiltrate were decreased. Increased hypoplasia of the bone marrow was observed after the chemotherapy.
The enlargement of the thyroid is, in general, benign in origin and due to nodular goitre. Follicular cellular proliferation of thyroid nodules has been increasingly observed recently. With fine needle aspiration biopsy (FNAB) this is classified as a follicular tumour. These lesions present various patterns of vascularisation in ultrasound examination. The aim of the study was to establish the relation between follicular nodule vascularisation and the proliferative activity of various types of follicular cell. According to the manner of proliferation, patients were divided into groups as follows: (I) patients with hyperplastic nodules (46 cases), (II) patients with follicular adenoma (42 cases), and (III) patients with follicular cancer (9 cases). In each case B-mode sonography, Power Doppler, sonographically guided FNAB (S-FNAB), morphological examination and morphometry were performed. The proliferative activity was detected with immunohistochemical methods (PCNA, Ki 67 and MPM2) to determine the so-called “proliferative index”. The study revealed increased proliferative activity in tumours of malignant origin and increased vascularisation in coexistence with increased proliferation of the follicular cells. As assessed by Power Doppler, an increased flow pattern in the centre of the nodules correlates with increased proliferative activity. The results suggest that Power Doppler examination could be helpful in selecting nodules for FNAB, especially in multinodular goitre.
The aim of the study was an estimation of the histomorphometry of megakaryocytes (MK) in bone marrow in selected myeloproliferative and lymphoproliferative diseases. Bone marrow specimens were obtained by trephine biopsies from 41 patients with polycythaemia rubra vera (PV), idiopathic myelofibrosis (MF), chronic lymphocytic leukaemia (CLL), hairy cell leukaemia (HCL) and diffuse large B-cell lymphoma (L). Morphometric evaluation was performed using a standard program set MicroImage (OLYMPUS). The greatest number of typical nucleated MK, “naked” nuclei, anucleated cytoplasmic fragments and the largest area were found in PV. The circular deviation factor of MK and their nuclei increased in all cases. The greatest number of clusters was observed in PV and HCL. A significant increase in the number of dysplastic and “naked” nuclei of MK was noted in all selected haematological diseases. The presence of neoplastic cells in bone marrow increased the morphological changes in MK. Quantitative and morphometrical significant differentiation of MK in separate microscopic field in the same slides confirms the necessity of performing trephine biopsies in each patient with haematological disorders.
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