AI Article Synopsis
- Bone marrow necrosis (BMN) is a rare condition often presenting with bone pain, fever, and decreased blood cell counts, and it is an unusual presentation in patients with acute lymphoblastic leukaemia (ALL).
- A 22-year-old male experienced symptoms like lower back pain and fever for two weeks, leading to extensive investigations that revealed severe neutropenia and extensive necrosis in his bone marrow biopsies.
- The diagnosis of ALL was complicated due to the presence of only a few immature lymphoid cells amidst the necrosis, highlighting the rarity and diagnostic challenges of combining BMN with ALL.
Article Abstract
Background: Bone marrow necrosis (BMN) is a rare entity which presents with bone pain, fever, and peripheral cytopenia. Acute lymphoblastic leukaemia (ALL) is characterized by malignant proliferation of immature lymphocytes, and patients usually present with fatigue and bleeding manifestations. Presentation with BMN is an extremely rare finding and only few cases had been reported in the literature. . A 22-year-old male presented with nocturnal lower back ache, pleuritic central chest pain, and fever for two weeks. He was extensively investigated for a cause. His investigations revealed pancytopenia with severe neutropenia. Initial bone marrow aspiration and biopsy did not provide a positive result due to extensive necrosis. However, immunohistochemical analysis of few immature lymphoid cells on repeated BM biopsy showed evidence of acute lymphoblastic leukaemia.
Conclusions: ALL usually presents with fatigue and bleeding manifestations. Presentation with BMN is extremely rare. The diagnosis was extremely challenging as this patient had only occasional atypical cells in the peripheral blood film and the repeat bone marrow (BM) biopsy showed extensive necrosis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468619 | PMC |
| http://dx.doi.org/10.1155/2020/8889850 | DOI Listing |
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