作者报告经骨髓穿刺确诊恶性组织细胞增生症21例,男16例,女5例,发病年龄5～63岁,以20～50岁居多。21例均有发热、贫血,其中15例有淋巴结肿大,19例肝肿大,14例脾肿大。8例外周血发现异常组织细胞,其比例为1～18%,骨髓中异常组织细胞比例为8～86%。恶组主要累及淋巴结、脾、肝、骨髓等造血器官,骨穿为诊断本病的重要手段,可疑病例要辅以其他组织活检。要重视与“反应网”鉴别,临床分型问题有待进一步探讨。 The authors report 21 cases of malignant histiocytosis diagnosed by bone marrow ascites, 16 males and 5 females, the age of onset of 5 to 63 years old, mostly in the 20 to 50 years old. Twenty-one patients had fever and anemia. Among them, 15 had swollen lymph nodes, 19 had hepatomegaly and 14 had splenomegaly. Eight cases of abnormal blood cells found in peripheral blood, the ratio was 1 to 18%, the proportion of abnormal tissue cells in bone marrow was 8 to 86%. Evil group mainly involves lymph nodes, spleen, liver, bone marrow and other hematopoietic organs, bone wear for the diagnosis of the disease an important means of suspicious cases should be supplemented by other biopsies. Should pay attention to the “reaction network” identification, clinical classification issues to be further explored.