Bone Marrow Necrosis: Frequency and Clinicopathological Findings in Marrow Biopsies

Bone marrow necrosis (BMN) is a rare and ominous complicationof wide variety of diseases including hematologic malignancy. This study was performed to identifyfrequency and the underlying associated diseases of marrow necrosis. In this descriptive study, totally 850 bone marrow trephine biopsiesrelated to living patients at the Pathology Department of Urmia Imam Hospital from March 1998 toJanuary 2008, were retrospectively reviewed. The reviews included clinical and laboratory findingsfrom files of the patients. Eight cases of bone marrow necrosis were found. Frequency was 0.94 percent. Ages ofthe patients were between 18 and 85 years, and four of them were female. Prominent symptoms ofthe patients were bone pain, fever, fatigue, and jaundice. The most common laboratory findingswere anemia, cytopenia, elevated lactate dehydrogenase (LDH), and alkaline phosphatase (ALP).Underlying diseases of bone marrow necrosis in our patients includes systemic lupus erythematosus,multiple myeloma, metastatic gastric cancer, acute myeloid leukemia (M4), hairy cell leukemia,lymphoma, chronic myeloid leukemia and sepsis. Our findings suggest that the conditions associated with BMN are varied andmalignancy remains common. In cases presented with pyrexia, bone pain, pancytopenia, elevatedLDH and ALK, marrow necrosis must be thought. Although prognosis is very bad, supplementarytherapy, in addition to the underlying disease must be performed.