No abstract available.
Bone Marrow Examination* ; Bone Marrow*

OBJECTIVE: To investigate the clinical significance of bone marrow unclassifiable cells in diagnosis of fever of unknown origin(FUO). METHODS: The clinical data of 60 patients with FUO admitted in the first affiliated hospital of Xi'an Jiaotong university from June 2014 to May 2016 were collected, and 60 patients with FUO were divided into 2 group: group A(30 cases) in which the unclassifiable cells in bone marrow were observed by bone marrow examination, and group B(30 cases) in which the unclassifiable cells in bone marrow not were found by bone marrow examination. The clinical characteristics, bone marrow features, immunophenotypes of bone marrow cells and prognosis of patients in 2 groups were analyzed retrospectively. RESULTS: Out of 30 patients in group A, 18 were diagnosed as malignant tumors including 12 cases of lymphoma, while out of 30 patients in group B, 5 cases were diagnosed as malignant tumor, including 3 cases of lymphoma. For the patients with non-tumor diseases, the bone marrow unclassifiable cells disappeared after the patients condition was improved. CONCLUSION The bone marrow examination including the smear and biopsy shonld be performed routinely for the patients with FUO. If the unclassifiable cells are observed morphologically in bone marrow of patients with FUO, the disease of patients should be considered as malignant tumor, especially, lymphoma.
Bone Marrow ; Bone Marrow Cells ; Bone Marrow Examination ; Fever of Unknown Origin ; Humans ; Retrospective Studies

Behcet's disease (BD) is a systemic vasculitis of unknown etiology that is rarely observed in association with leukemia and other hematologic disorders. We recently encountered a patient who presented with BD associated with myelofibrosis that was not attributable to other underlying causes. The patient was a 49-year-old man with a 3-year history of probable BD diagnosed by clinical findings; he was admitted because of anemia and splenomegaly. Bone marrow examination revealed myelofibrosis. After steroid therapy, the patient's symptoms of BD improved, and his hemoglobin level recovered. Therefore, we believe that the patient had BD with bone marrow involvement.
Anemia ; Bone Marrow ; Bone Marrow Examination ; Hemoglobins ; Humans ; Leukemia ; Middle Aged ; Primary Myelofibrosis ; Splenomegaly ; Systemic Vasculitis

OBJECTIVEThis study was aimed to evaluate the significance of bone marrow(BM) morphological examination and many tumor marker(TM) detection, especially carcinoembryonic antigen (CEA), cancer antigen 125(CA125), cancer antigen 15-3 (CA15-3) and serum ferritin (SF) for lymphoma diagnosis and prognosis.

METHODSA total of 47 confirmed patients with lymphoma in our hospital from January 2012 to October 2013 and 20 health peoplels as normal controls were performed with bone marrow morphological examination, at the same time, the electrochemistry luminescent technique was applied for detecting levels of TM (especially CEA, CA125, CA15-3 and SF) in serum samples of lymphoma patient and normal controls, then the BM immature lymphocyte counts of these people and clinical parameters were analyzed for diagnosis and prognosis.

RESULTSThere was significant differences in all the four TM levels between serum samples of lymphoma patients and normal control (P=0.029, P=0.000, P=0.005, P=0.000). These TM levels had no correlation with age, sex white blood cell, lymphocyte, platelet counts and anemia of lymphoma patients (P>0.05). It was also found that the patients with elevated TM levels had high BM immature lymphocytes (lymphoma cells) counts, B symptoms, advanced clinical stage and high IPI index (P<0.05). The CA15-3 and SF levels in serum samples of lymphoma patients with BM infiltration were higher than that in lymphoma patients without BM infiltration (P=0.002, P=0.000).

CONCLUSIONCombination of BM morphological examination with serum TM level detection plays an important role in diagnosis, clinical stage and prognosis evaluation of lymphoma patients. It is also very important for assessing BM infiltration status of lymphoma patients.

Human brucellosis is an important zoonotic disease and has a wide clinical spectrum. Nonspecific hematologic abnormalities related to brucellosis are frequently found, but pancytopenia is uncommon. Malignant diseases have been infrequently reported as a rare cause of pancytopenia in patients with brucellosis. We describe a patient with brucellosis and pancytopenia who was later diagnosed with acute myeloid leukemia. A 71-yr-old man was admitted to a hospital with fever and pancytopenia. Brucella was cultured from blood, and the bone marrow findings were in accordance with brucellosis. The patient's clinical symptoms improved; however, he still showed pancytopenia after completion of medical treatment. After approximately 6 months, he was readmitted with pneumonia and pancytopenia. The second bone marrow examination revealed hypercellular marrow with increased number of blasts. The chromosome analysis showed 46,XY,trp(8)(q11.2q22)[8]/46,idem,del(7)(q22)[12]. The patient was diagnosed with acute myeloid leukemia with myelodysplasia-related changes. He refused further evaluation and therapy, and subsequently died while receiving conservative treatment.
Bone Marrow ; Bone Marrow Examination ; Brucella ; Brucellosis* ; Fever ; Humans ; Leukemia, Myeloid, Acute* ; Pancytopenia* ; Pneumonia ; Zoonoses

OBJECTIVETo investigate the role of cytogenetic analysis in the detection of bone marrow (BM) involvement in patients with non-Hodgkin's lymphoma (NHL).

METHODSThe bone marrow samples of 74 patients with NHL were detection by using morphology, cytogenetic test, flow cytometry and molecular biological assay. The detected results of morphology, cytogenetic test, flow cytometry and molecular biological assay alone and thier combined detection were compared, the detective rate and consistencies of the 4 methods were analyzed.

RESULTSThe detection rates of BM involvement by using morphology, cytogenetic, flow cytometry, and molecular biological assays were 21.6%, 17.6%, 23.0% and 33.8% respectively. The detective rate was enhanced to 44.6% by combining the 4 methods. Cytogenetic test showed the result consistent with the other methods.

CONCLUSIONAlthough cytogenetic test shows a lower detective rate than the other methods, but in some patients the cytogenetic test can detect the abnormality of bone marrow which can not be detected by other methods alone, the combination test of 4 detection methods can enhance the detectable rate of BM involvement.

OBJECTIVETo explore the value of bone marrow smear and biopsy simultaneously applied to diagnosis of multiple myloma (MM).

METHODSClinical data of 30 cases of multiple myloma were collected from our hospital in the year 2014 and analyzed retrospectively, and the results of the bone marrow smear and the simultaneous bone marrow biopsy were compared.

RESULTSHyperplasia levels in bone marrow biopsy was significantly higher than that in bone marrow smears, and the active and highly active hyperplasia of nucleated cells were observed in all the bone marrow biopsies; the myeloma cells showed a focal or diffuse distribution, the binuclear or polynuclear myeloma cells were observed in 22 patients (73%), but the detection rate of abnormal myeloma cells was 40% in bone marrow smear (P < 0.05). There was mild to moderate hyperplasia of fibrous tissue in bone marrow biopsy, and the hyperplasia degeree of fibrous tissue strongly positively correlated with the myeloma cell ratio (r = 0.412).

CONCLUSIONThe bone marrow smear and aspiration biopsy can complement each other so as to reduce the misdiagnosis rate, therefore contributes to the early diaglosis and treatment.

Biopsy, Needle ; Bone Marrow ; pathology ; Bone Marrow Examination ; Female ; Humans ; Infant, Newborn ; Male ; Sternum ; pathology

OBJECTIVETo explore the morphological characteristics of bone marrow cells of multiple myeloma with non-bone-related extramedullary disease and thier clinical significance.

METHODSBone marrow smears, peripheral blood smears and bone marrow biopsy sections as well as thier examination results of 20 cases of multiple myloma with non-bone-related extramedullary disease were collected at initial diagnosis in First Affiliated Hospital of Xi'an Jiaotong University from March 2013 to March 2016, and morphological characterisistes of bone marrow cells were analysed in combination with clinical data.

RESULTSThe morphology of plasma cells in 20 patients showed 2 cytologic subtypes: primitive cell type (16 cases) and pleomorphic type (4 cases). Immature plasma cells were found in the 5 patients' peripheral blood smear, accounting for about 1%-4% of the number of peripheral blood cells. In bone marrow tissue, plasma cells hyperproliferated with nodular and packed type, and secondary myelofibrosis counted for 12 cases (60%). 13 MM patients whose non-bone-related extramedullary disease occurred during therapy were divided into 2 groups according to the marrow fibrosis density. The median time from diagnosis of MM to extramedullary lesions resulting from fibrosis 0-1 grade and 2-3 grade was 23.7±3.7 months and 10.5±3.2 months ahead of the former(P=0.025).

CONCLUSIONBone marrow plasma cell morphology of multiple myeloma with non-bone-related extramedullary disease at the initial diagnosis is mostly immature type, and plasma cells proliferate with nodular and packed type and accompanied by different degree of fibrosis. The degree of myelofibrosis indirectly reflects the degree of proliferation and malignancy of the bone marrow plasma cells, which maybe possess some value in predicting extramedullary disease in the early stages of the MM.

A 38-year-old woman who presented with unexplained fever and pancytopenia was subjected to a bone marrow examination. Her bone marrow aspirate smear showed no obvious pathological finding except for the presence of hemophagocytosis and mild plasmacytosis. In view of hemophagocytosis, a thorough examination of the smear was conducted and revealed the presence of histoplasmosis. She was advised to undergo evaluation of her immunological status, and she tested positive for human immunodeficiency virus (HIV) infection. This case highlights that hemophagocytosis in the marrow may be an early sign of underlying disease, and that careful examination of bone marrow smears may reveal subtle infections. In addition, histoplasmosis with hemophagocytosis may be associated with pancytopenia, and hence, the HIV status of the patient should always be investigated.
Adult ; Bone Marrow ; Bone Marrow Examination ; Female ; Fever ; Histoplasmosis ; HIV ; Humans ; Pancytopenia