Pancytopenia due to bone marrow necrosis in acute myelogenous leukemia: role of reactive CD8 cells.
Bone marrow necrosis is a rare clinical condition often associated with hematological malignancy. The mechanism by which malignant disease causes marrow necrosis is unknown. We present a case of a patient with newly diagnosed pancytopenia with bone marrow biopsy evidence of extensive marrow necrosis. Upon further work-up utilizing Tc bone scan directed bone marrow biopsy, a massive CD8+ T cell marrow infiltrate was discovered engulfing AML-M2 blasts. The role of Tc bone scans in the work-up of bone marrow necrosis as well as the potential mechanism of AML-M2 induced marrow necrosis in the setting of reactive CD8+ T cell infiltration is discussed.
Markovic
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Division of Hematology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Phyliky
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Li
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D000368:Aged; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D018414:CD8-Positive T-Lymphocytes / Q000502:physiology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D009336:Necrosis; D010198:Pancytopenia / Q000209:etiology*; D011877:Radionuclide Imaging; D013667:Technetium
D013667:Technetium