@article{oai:gunma-u.repo.nii.ac.jp:00007485,
 author = {Toyama, Kohtaro and Mitsui, Takeki and Yokohama, Akihiko and Saitoh, Takayuki and Uchiumi, Hideki and Handa, Hiroshi and Sakuraya, Masataka and Murakami, Hirokazu and Nojima, Yoshihisa and Tsukamoto, Norifumi},
 issue = {2},
 journal = {The Kitakanto medical journal = 北関東医学},
 month = {May},
 note = {Journal Article, A 64-year-old woman,with more than a 20 year history of polycythemia vera(PV),developed portal\nhypertension,myelofibrosis and extramedullary hematopoiesis accompanied by massive ascites. Portal\nhypertension resulted not only from infiltration of the liver sinusoids by hematopoietic cells but also from\nnodular regenerative hyperplasia of the liver. Wright-stained smears of ascites samples consisted of\nmesothelial cells and macrophages. However,cultures of mononuclear cells from the ascites showed the\npresence of hematopoietic progenitor cells including megakaryocyte colony formation and burst forming\nunits. The JAK2-V617F mutation was positive in granulocytes. Contrary to other reports, radiation\ntherapy was not effective and severe myelosuppression continued for more than one month. We present\nthe unusual clinical course for this case of PV and discuss the pathophysiology of refractory ascites.},
 pages = {159--162},
 title = {Polycythemia Vera Terminating in Refractory Ascites},
 volume = {62},
 year = {2012}
}