[Bone marrow granulomas].
OBJECTIVE
To evaluate bone marrow granulomatous lesions in order to establish their etiology.


METHODS
2,250 bone marrow biopsies were studied during the period of March 1983-March 1991. Granulomas and/or granulomatous lesions were found in 24 of them (1.06%). A correlation between histological characteristics, special stains: PAS, Ziehl Neelsen and Grocott and cultures were done. Immunohistochemistry was done to evaluate B or T cell-lineage in 4 patients.


RESULTS
The 24 patients were biopsied because of the clinical diagnosis of haematological and non-haematological neoplasias, infections, AIDS, sarcoidosis and fever of unknown origin. Bone marrow cellularity ranged from 20% to 75% (M: 49.8%). Myeloid cells were increased in 54% of the cases. The number of granulomas ranged from 1 to 19 (M: 3.9). The epithelioid cells were the predominant component in 66% of the cases. Of the 7 patients with non-Hodgkin's lymphoma, 4 had lymphomatous involvement with granulomatous pattern. These cases showed predominance of lymphoid cells and vessels in addition to epithelioid cells.


CONCLUSIONS
We consider that in order to establish a relationship between infection and granuloma, the identification of a microorganism through a culture is a more reliable test. We couldn't find any morphological characteristic which allowed an etiologic diagnosis of bone marrow granulomas. In case of lesions with a great lymphocytic and vascular proliferation plus the presence of epithelioid cells and fibrosis, NHL with bone marrow involvement with a granulomatous pattern should be strongly considered.
Vijnovich Barón
I A
IA
Departamento de Patologíay Citología, Sanatorio Güemes, Buenos Aires, Argentina.
Barazzutti
L
L
Tartas
N
N
Korin
J
J
Sánchez Avalos
J C
JC
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D001855:Bone Marrow Diseases / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000469:parasitology / Q000473:pathology; D001856:Bone Marrow Examination; D003453:Cryptococcosis / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005335:Fever of Unknown Origin / Q000150:complications; D006099:Granuloma / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000469:parasitology / Q000473:pathology; D006660:Histoplasmosis / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007085:Ilium; D015994:Incidence; D008228:Lymphoma, Non-Hodgkin / Q000150:complications; D008297:Male; D008875:Middle Aged; D014375:Tuberculoma / Q000453:epidemiology / Q000473:pathology
Granulomas en medula ósea.