Granulomatous bone marrow disease. A review of the literature and clinicopathologic analysis of 58 cases

We have reviewed 58 cases of bone marrow granuloma at a single institution over a 20-year time span, and have summarized the available English literature. We conclude that bone marrow granulomas are an infrequent pathologic finding which, when found, require definition as to an underlying etiology....

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Bibliographic Details
Published in:Medicine (Baltimore) 1983-11, Vol.62 (6), p.372-383
Main Authors: Bodem, C R, Hamory, B H, Taylor, H M, Kleopfer, L
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Autoimmune Diseases - complications
Bone Marrow Diseases - complications
Bone Marrow Diseases - etiology
Bone Marrow Diseases - pathology
Child
Cytomegalovirus Infections - complications
Female
Granuloma - complications
Granuloma - etiology
Granuloma - pathology
Histoplasmosis - complications
Hodgkin Disease - complications
Humans
Infectious Mononucleosis - complications
Lymphoma - complications
Male
Middle Aged
Mycoses - complications
Sarcoidosis - complications
Tuberculosis, Miliary - complications
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Summary:We have reviewed 58 cases of bone marrow granuloma at a single institution over a 20-year time span, and have summarized the available English literature. We conclude that bone marrow granulomas are an infrequent pathologic finding which, when found, require definition as to an underlying etiology. Undoubtedly, the illnesses associated with marrow granuloma are similar to those causing granulomatous hepatitis. The following additional statements may justifiably be made based on this review. There are no morphologic features which allow reliable differentiation between the causes of bone marrow granuloma. By combining careful histologic, microbiologic, and serologic techniques, an etiology can be documented in most (87%) patients with marrow granulomas. A medication history is an important element of this evaluation. Rocky Mountain spotted fever, cytomegalovirus infection, ibuprofen, acute lymphocytic leukemia, and various collagen vascular diseases should be added to the list of causes of marrow granuloma. The prognostic significance of marrow granuloma in patients without an ascertainable underlying illness remains unclear.
ISSN:0025-7974
DOI:10.1097/00005792-198311000-00003