The clinical & morphologic characteristics of bone marrow necrosis in 3 patients were
evaluated & compared to those in the literature.
1) The incidence of bone marrow necrosis was 0.12% of 2,477 biopsies.
2) The underlying diseases of 3 patients were hepatoma, ITP & adenocarcinoma of
stomach , respectively
3) All 3 patients showed anemia & thrombocytopenia. In peripheral blood smear,
schistscytes were observed in all cases & normoblast in 1 case. Coagulation study
revealed prolonged PT & PTT of variable degree & increased FDP in all cases which
were compatible with DIC.
4) Bone marrow aspiration smears showed markedly decreased in number of normal
hematopoietic ce11s & irregular clusters of destroyed cells with dense nuclear staining.
Cytoplasmic margins were obscure. Backgrounds were filled with dirty, basophilic,
granular materials.
5) Bone marrow biopsies showed disappearance of normal hematopoietic cells &
connective infrastructure with indistinct meshwork of eosinophilic debris dispersed
throughout the marrow. In case 3, necrosis of marrow was less extensive than the
others & some erythoid & myeloid islands were observed.
6) Outcome of necrosis was different in all 3 patients. One with hepatoma died on 10
th hospital day, one with ITP showed recovery pattern from necrosis on second marrow
examination done after 1 month without specific changes in clinical & peripheral blood
findings.
One with stomach cancet lost follow up.
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