title: Bone marrow features of diagnostic impact in erythrocytosis.
abstract: Controversy continues to persist about the role of histopathology regarding diagnosis of polycythemia vera (PV). For this reason, a clinicopathological study was performed on 334 patients presenting with a sustained borderline to marked erythrocytosis (hemoglobin >17 g/dl in men and >15 g/dl in women). The aim was to elucidate the discriminating impact of bone marrow biopsy examinations in an independent fashion from laboratory parameters. According to morphological findings based on a semiquantitative evaluation of standardized features, cellularity, megakaryocytes (quantity, size, pleomorphous aspect, clustering, nuclear lobulation), eosinophils, cellular debris, perivascular plasmacytosis and iron-laden macrophages exerted a distinctive value. Comparison with clinical data and follow-up revealed that in only 13 patients (4%), histopathology failed to differentiate clearly between PV (208 patients) and secondary polycythemias (113 patients). In conclusion, certain sets of morphological parameters allow a distinction between autonomous and reactive polycythemias and therefore enhance significantly diagnostic validity.
authors.affiliation: Institute of Pathology, University of Cologne, Joseph-Stelzmannstr. 9, 50924, Cologne, Germany. j.thiele@uni-koeln.de
authors.forename: Juergen
authors.initials: J
authors.lastname: Thiele
authors.forename: Hans Michael
authors.initials: HM
authors.lastname: Kvasnicka
authors.forename: Volker
authors.initials: V
authors.lastname: Diehl
mesh_terms: D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D001854:Bone Marrow Cells / Q000648:ultrastructure; D001856:Bone Marrow Examination; D002452:Cell Count; D048429:Cell Size; D004804:Eosinophils / Q000648:ultrastructure; D004921:Erythropoietin / Q000097:blood; D005260:Female; D006400:Hematocrit; D006801:Humans; D007501:Iron / Q000032:analysis; D008264:Macrophages / Q000737:chemistry / Q000648:ultrastructure; D008297:Male; D008533:Megakaryocytes / Q000648:ultrastructure; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000473:pathology; D015388:Organelles / Q000648:ultrastructure; D010950:Plasma Cells / Q000648:ultrastructure; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis; D011086:Polycythemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D011087:Polycythemia Vera / Q000175:diagnosis / Q000473:pathology; D055728:Primary Myelofibrosis / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D012155:Reticulin / Q000648:ultrastructure; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012907:Smoking / Q000009:adverse effects
chemical_list: D012155:Reticulin; D004921:Erythropoietin; D007501:Iron