American Journal of Internal Medicine

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Bone Marrow Granulomas: A Retrospective Study of 47 Cases (A Single Centre Experience)

Received: 11 September 2014    Accepted: 29 September 2014    Published: 20 October 2014
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Abstract

Background: Granulomas in bone marrow are an infrequent finding; however several diseases may be associated with granuloma formation and an etiologic diagnosis is essential. Bone marrow examination plays an important role in the diagnosis of various disorders associated with bone marrow granulomas and is useful in the investigation of pyrexia of unknown origin (PUO) as it leads to an etiological diagnosis in many of the cases. Aim: This study was undertaken to ascertain the frequency and etiological background of bone marrow granulomas. Material and methods: In the present study, forty seven cases with bone marrow granulomas were included. Clinical details, peripheral blood and marrow morphological findings were analyzed. Results: Pyrexia of unknown origin was the commonest presentation and anemia was noted in all cases. Twenty five cases had associated clinical conditions, including 7 with past history of tuberculosis and 8 with retroviral disease. Of the 47 cases, 7 showed granulomas in bone marrow aspiration, while bone marrow biopsy was diagnostic in all cases. Caseous necrosis was seen in 11(23.4%) cases. Acid fast bacilli were demonstrated in one bone marrow aspirate. Culture studies grew Brucella organisms in one case. Tuberculosis was the commonest in the present study as compared to other studies probably due to the endemicity of tuberculosis in this region. Conclusion: If the granuloma is associated with caseous necrosis and Langhan giant cells and correlated with clinical features, a possibility of the tuberculous etiology may be suggested to allow empirical treatment to be initiated before microbiological confirmation.

DOI 10.11648/j.ajim.20140205.13
Published in American Journal of Internal Medicine (Volume 2, Issue 5, September 2014)
Page(s) 90-94
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Bone Marrow Aspiration, Granuloma, PUO, Trephine Biopsy, Tuberculosis

References
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Author Information
  • Departments of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, India

  • Departments of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, India

  • Departments of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, India

  • Departments of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, India

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    Sampath Kumar-Kandala Jeevan, Roshni Paul-Tara, Shantiveer Uppin, Megha Uppin. (2014). Bone Marrow Granulomas: A Retrospective Study of 47 Cases (A Single Centre Experience). American Journal of Internal Medicine, 2(5), 90-94. https://doi.org/10.11648/j.ajim.20140205.13

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    ACS Style

    Sampath Kumar-Kandala Jeevan; Roshni Paul-Tara; Shantiveer Uppin; Megha Uppin. Bone Marrow Granulomas: A Retrospective Study of 47 Cases (A Single Centre Experience). Am. J. Intern. Med. 2014, 2(5), 90-94. doi: 10.11648/j.ajim.20140205.13

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    AMA Style

    Sampath Kumar-Kandala Jeevan, Roshni Paul-Tara, Shantiveer Uppin, Megha Uppin. Bone Marrow Granulomas: A Retrospective Study of 47 Cases (A Single Centre Experience). Am J Intern Med. 2014;2(5):90-94. doi: 10.11648/j.ajim.20140205.13

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  • @article{10.11648/j.ajim.20140205.13,
      author = {Sampath Kumar-Kandala Jeevan and Roshni Paul-Tara and Shantiveer Uppin and Megha Uppin},
      title = {Bone Marrow Granulomas: A Retrospective Study of 47 Cases (A Single Centre Experience)},
      journal = {American Journal of Internal Medicine},
      volume = {2},
      number = {5},
      pages = {90-94},
      doi = {10.11648/j.ajim.20140205.13},
      url = {https://doi.org/10.11648/j.ajim.20140205.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20140205.13},
      abstract = {Background: Granulomas in bone marrow are an infrequent finding; however several diseases may be associated with granuloma formation and an etiologic diagnosis is essential. Bone marrow examination plays an important role in the diagnosis of various disorders associated with bone marrow granulomas and is useful in the investigation of pyrexia of unknown origin (PUO) as it leads to an etiological diagnosis in many of the cases. Aim: This study was undertaken to ascertain the frequency and etiological background of bone marrow granulomas. Material and methods: In the present study, forty seven cases with bone marrow granulomas were included. Clinical details, peripheral blood and marrow morphological findings were analyzed. Results: Pyrexia of unknown origin was the commonest presentation and anemia was noted in all cases. Twenty five cases had associated clinical conditions, including 7 with past history of tuberculosis and 8 with retroviral disease. Of the 47 cases, 7 showed granulomas in bone marrow aspiration, while bone marrow biopsy was diagnostic in all cases. Caseous necrosis was seen in 11(23.4%) cases. Acid fast bacilli were demonstrated in one bone marrow aspirate. Culture studies grew Brucella organisms in one case. Tuberculosis was the commonest in the present study as compared to other studies probably due to the endemicity of tuberculosis in this region. Conclusion: If the granuloma is associated with caseous necrosis and Langhan giant cells and correlated with clinical features, a possibility of the tuberculous etiology may be suggested to allow empirical treatment to be initiated before microbiological confirmation.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Bone Marrow Granulomas: A Retrospective Study of 47 Cases (A Single Centre Experience)
    AU  - Sampath Kumar-Kandala Jeevan
    AU  - Roshni Paul-Tara
    AU  - Shantiveer Uppin
    AU  - Megha Uppin
    Y1  - 2014/10/20
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ajim.20140205.13
    DO  - 10.11648/j.ajim.20140205.13
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 90
    EP  - 94
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20140205.13
    AB  - Background: Granulomas in bone marrow are an infrequent finding; however several diseases may be associated with granuloma formation and an etiologic diagnosis is essential. Bone marrow examination plays an important role in the diagnosis of various disorders associated with bone marrow granulomas and is useful in the investigation of pyrexia of unknown origin (PUO) as it leads to an etiological diagnosis in many of the cases. Aim: This study was undertaken to ascertain the frequency and etiological background of bone marrow granulomas. Material and methods: In the present study, forty seven cases with bone marrow granulomas were included. Clinical details, peripheral blood and marrow morphological findings were analyzed. Results: Pyrexia of unknown origin was the commonest presentation and anemia was noted in all cases. Twenty five cases had associated clinical conditions, including 7 with past history of tuberculosis and 8 with retroviral disease. Of the 47 cases, 7 showed granulomas in bone marrow aspiration, while bone marrow biopsy was diagnostic in all cases. Caseous necrosis was seen in 11(23.4%) cases. Acid fast bacilli were demonstrated in one bone marrow aspirate. Culture studies grew Brucella organisms in one case. Tuberculosis was the commonest in the present study as compared to other studies probably due to the endemicity of tuberculosis in this region. Conclusion: If the granuloma is associated with caseous necrosis and Langhan giant cells and correlated with clinical features, a possibility of the tuberculous etiology may be suggested to allow empirical treatment to be initiated before microbiological confirmation.
    VL  - 2
    IS  - 5
    ER  - 

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