Lösemi mi, Hematogon mu? (Olgu Sunumu)
Hematogonlar kemik iliğinin rejenerasyonu sırasında görülebilen B lenfosit kökenli immatür
hücrelerdir. Bunlar bazofilik, dar sitoplazmalı, nükleus stoplazma oranı büyük, homojen kromatine
sahip, bazen nükleolus içeren ancak granül ihtiva etmeyen hücrelerdir. Morfolojik olarak akut
lenfoblastik lösemi veya lenfoblastik lenfomada görülen blastlara benzemelerinden dolayı, sayılarının
arttığı durumlarda tanısal problemlere neden olurlar. İnfantlarda nedeni bilinmeyen viral enfeksiyonlar,
yüksek doz kemoterapi sonrasında kemik iliğinde artmış oranda görüldükleri bildirilmiştir. Uzamış
sarılık nedeni ile hastanemize başvuran ve lenfositoz nedeni ile izleme alınan üç aylık erkek hasta, klinik
ve hematolojik değerleri lösemiyi çağrıştırsa da, yenidoğanlarda ve infantlarda lösemi tanısı konurken
hematogonların dışlanmasının gerekliliğini vurgulamak amacı ile tartışılmıştır.ABSTRACT
B-lymphocyte progenitor cells, so-called hematogones, and mature B lymphocytes are normal bone
marrow constituents, which are more prominent in the pediatric bone marrow. Increased numbers of
hematogones may cause problems in diagnosis because of the morphologic features they commonly
share with the neoplastic lymphoblasts of acute lymphoblastic leukemia and lymphoblastic lymphoma.
However, an increase in some of hematogones due to unknown viral infections, after high dose
chemotherapy had been rarely reported in the literature. We describe here a case of a three-month-old
male infant with lymphocytosis associated with increased hematogones in the bone marrow due to an
unknown probable viral infection.
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