Granulomatous Lesions in Bone Marrow

Abstract

A survey has been made of granulomatous lesions found in sections of bone marrow from 150 patients studied at the Mayo Clinic. These lesions have been found in a variety of disorders, some with known etiologic agents and others with unknown causes. With the exception of tuberculosis, histoplasmosis and brucellosis, in which the causative organisms were seen and identified bacteriologically, the granulomatous lesions were not thought to have any distinctive histopathologic characteristics. Prominent lesions, Langhans’ giant cells and necrosis were more common in the marrow of patients with disorders known to be associated with a granulomatous inflammatory process than they were in associations with other conditions.

Clinical and pathological feature of bone marrow granulomas: A modern Australian series

“…This is consistent with low previous rates of detection. Pease showed only 4 of 19 cases had AFBs identified within the marrow granulomas, Bodum found 2 of 4 and Brackers de Hugo none of 10 cases with military tuberculosis. Given the low rate of cases and the low sensitivity of ZN staining for tuberculosis, the value of this stain is questioned in the marrow.…”

“…These are similar to the rate in the current study of 1.2% (1.1%, excluding patients with repeated biopsies showing granulomas). Pease described a series of 150 of marrow granulomas from the Mayo Clinic in 1956, but the rate at which they occurred was not stated, and the sensitivity may have differed as the samples were sternal aspirate clot sections. The predominant cause of granuloma was infection, particularly tuberculosis.…”

Silicotic lesions of the bone marrow: histopathology and microanalysis

“…Among the more important diseases manifesting bone marrow granulomas are tuberculosis, sarcoidosis, Hodgkin's diesease, brucellosis, mycoses, and viral infections, such as infectious mononucleosis (Gormsen 1948, Hovde & Sundberg 1950, Pease 1956, Kadin, Donaldson & Dorfman 1970. In a large proportion of cases of bone marrow granulomas the aetiology is not apparent (Pease 1956).…”

Bone Marrow Findings in Infectious Mononucleosis and Mononucleosis‐Like Diseases in the Older Adult

“…In addition, a prevalent notion prevails that the bone marrow is normal in IM. However, in several studies (Campbell 1948, Schleicher 1949, Hovde & Sundberg 1950, Pease 1956 Reid 1968) where a systematic examination of the marrow has been done, changes have been noted including lymphocytosis, granulocytic and/or erythroid hyperplasia and not infrequently, granulomas. Although the granulomas have no specific diagnostic feature, giant cells tend to be infrequent and the granulomas are usually smaller than those in tuberculosis and sarcoidosis.…”