Bone marrow necrosis obscuring the diagnosis of acute promyelocytic leukemia.
Bone marrow necrosis is a rare and ominous complication of hematologic malignancy which is often associated with bone pain in the lower back and extremities. Widespread marrow necrosis makes a definitive diagnosis through bone marrow biopsy difficult. An accurate diagnosis is imperative in patients with promyelocytic leukemia (FAB-M3) because disseminated intravascular coagulation and hemorrhage secondary to release of tissue thromboplastins from the malignant cell population requires prompt and anticipatory therapy. The following case report describes a patient with acute leukemia and massive bone marrow necrosis which obscured the correct diagnosis of promyelocytic leukemia.
Wisecarver
J
J
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 68105.
Harrington
D
D
D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D009336:Necrosis