A clinicopathological analysis on nine cases of polycythemias, diagnosed by laboratory
data and bone marrow examination in the Department of Clinical Pathology of the
Catholic Medical Center from January 1972 to December 1979, was made and the
following results were obtained.
1) Of the total 9 cases, six were male and three female. Six cases were between 45
and 55 years of age. The remaining one was 68 years old, the other was 75 years old
and 30 years old.
2) The chief clinical manifestations at the time of the first examination was ruddy
cyanosis, splenomegaiy, hepatomegaly, gastrointestinal symptoms, dyspnea, hemorrhages
and thrombosis(Table 1) .
3) Among the laboratory findings(Table 2, 3), the hemoglobin was increased in all
cases, and 5 cases showed above 19 gm/dl. The hematocrit was also increased above
50% in a1l cases, the highest value was 70%. The morphology of erythrocytes revealed
fairly marked poikylocytosis with tear drop and polychromatophilic erythrocytes in 1
case, and relatively normal morphology in the remaining 8 cases. The erythrocyte counts
revealed above 7,000,000/cumm in 3 cases and normal limit in 2 cases. The MCH(mean
corpuscular hemoglobin) and MCV(mean corpuscular volume) were in normal limit in 4
cases of polythemia vera and 1 case of relative polycythemia, decreased in 2 cases of
polycythemia vera and increased in case of secondary polycythemia. The MCHC(mean
corpuscular hemoglobin concentration) was slightly decreased in 5 cases and normal in 2
cases of polycythemia vera but normal in both secondary and relative pelycythemia. The
leukocyte count of polycythemia vera revealed above 10,000/cumm in 5 cases and normal
in 2 cases. The leukocyte counts of the other two cases were normal. The platelet
counts revealed above 250,000/cumm in 4 cases of polycythemia vera and normal in all
the remaining cases. The serum uric acid showed above 7.8mg/dl in 5 cases and normal
in the other 4 cases, and the highest value was 12.5 mg/dl. The urine uric acid of three
cases showed increased value and it was not done in the other six cases.
4) The bone marrow findings revealed hypercellularity in 5 cases. The bone marrow
morphology, as judged by the Wright stained smears and hematoxylin eosin stained
tissue section particles, showed a marked increased of atypical and giant
megakaryocytes in 1 case, a marked increase in normal megakaryocytes in 1 case, mild
to moderate increase of normal megakaryocytes in the remaining 4 cases, slight increase
of immature megakaryocytes in 1 case, and the other relative and secondary
polycythemia were in normal number and morphology. The prussian blue reaction of
marrow particles revealed a decrease of iron pigment in the 4 cases of polycythemia
vera, and normal limit in 1 case of polycythemia vera, 1 case of secondary polycythemia
and 1 case of relative polycythemia
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