Transmission ultrastructure in the study of acquired refractory anemias
Woessner, S.; Lafuente, R.; Florensa, L.; Vilá, R.M.; Sans-Sabrafen, J.
Sangre 31(1): 40-56
1986
ISSN/ISBN: 0036-4355 PMID: 3458311 Document Number: 273269
A semi-quantitative ultrastructural evaluation was performed in 25 cases of acquired refractory anaemia, cytochemical-ultrastructural study being carried out in 18 of them. Dyserythropoiesis was found in 84 percent of refractory anaemias. Attention was mainly focused on dysgranulopoiesis and dysthrombopoiesis since they are less well documented. Ultrastructural degranulation of leucocytes was correlated with the optical findings and the content of myeloperoxidase and lactoferrin. Anomalous granules were present in 80 percent of the cases, followed by Dohle corpuscules (64 percent) nuclear pockets (52 percent) and pseudo-Pelger anomaly (44 percent). FAB types I and II blast-cells were identified along with normal and abnormal promyelocytes. Hypogranular micro-megakaryocytes with singles nucleus, megathrombocytes and "Swiss-cheese" platelets were the commonest anomalies found in the megakaryocytic-thrombocytic cell-line. Increased bone-marrow promegakaryoblasts were assessed by platelet peroxidase in one third of the refractory anaemias. Platelets are peroxidase positive in sideroblastic anaemia, whereas 57 percent of the non-sideroblastic varieties show peroxidase negative platelets as well. Since normal platelets are peroxidase positive, the presence of a double platelet population may represent an important dysthrombopoietic feature.