Bone Marrow Necrosis: An Unusual Misdiagnosed Serious Complication

Georges El Hachem
2017 International Journal of Blood Research and Disorders  
and BM infiltration with malignant cells, often of hematopoietic origin [3] . Here I am writing a review article based on literature reviews concerning BMN and related case reports. I will try to focus on clinical presentation, differential diagnosis, different etiologies, and its correlation with SCD, prognosis, and treatment. The aim of this review is to keep clinicians aware of this distinct, rare and fatal clinico-pathological entity, resulting in early suspicion, diagnosis, and thus better
more » ... is, and thus better prognosis. Discussion Bone marrow necrosis is an infrequent entity where BM is replaced by necrotic material with cells having indistinct cellular outlines and smudged nuclei, surrounded by amorphous eosinophilic material [4]. It ranges from localized to widespread generalized processes and is graded semi-quantitatively according to the extent of necrosis evident in the bone marrow biopsy. Grading was described by Maisel, et al. as follows: grade I (mild), less than 20% of the biopsy; grade II (moderate to intermediate), 20% to 50% of the biopsy; and grade III (severe to extensive), more than 50% of the biopsy specimen [5] . Most of the available data about bone marrow necrosis are from the post mortem studies because there was the lack of awareness and lack of documentation of the very few cases which were diagnosed during the lifetime of the patient. The incidence of BMN varies from 0.3 to 37% among different reports, with 90% of the cases being related to malignancy [3] . Of these, hematologic malignancies account for 60% of the cases with BMN identified at primary diagnosis or at relapse.
doi:10.23937/2469-5696/1410026 fatcat:pe56v5b55bdqvpi6oqjxrazoxa