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| IMAGE IN HEMATOLOGY |
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| Year : 2016 | Volume
: 7
| Issue : 2 | Page : 81-82 |
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Bone marrow tuberculosis: A diagnosis not to be missed
Nadeem Tanveer, Kavana Soni
Department of Pathology, University College of Medical Sciences, New Delhi, India
| Date of Web Publication | 14-Jul-2016 |
Correspondence Address:
Nadeem Tanveer
Department of Pathology, University College of Medical Sciences, Dilshad Garden, New Delhi - 110 095
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1658-5127.186330
How to cite this article:
Tanveer N, Soni K. Bone marrow tuberculosis: A diagnosis not to be missed. J Appl Hematol 2016;7:81-2 |
A 30-year-old male patient, resident of Delhi, presented with complaints of generalized body ache, easy fatigability, weight loss, and loss of appetite for 1 year. He was diagnosed HIV-positive a few days back; however, antiretroviral treatment had not been started. On examination, he had pallor with many small cervical and axillary lymph nodes. There was no hepatosplenomegaly. Ultrasound abdomen showed a few peripancreatic and retroperitoneal lymph nodes, largest being 1.5 cm in size. His hemogram was Hb - 5.0 g%, total leukocyte count - 2000/mm 3 , platelet count - 100,000/mm 3 , differential leukocyte count - polymorphs - 73%, lymphocytes - 20%, monocytes - 07%, and eosinophils - nil.
A bone marrow examination was performed as workup of pancytopenia. The bone marrow aspirate was hypocellular for age. The erythroid series showed normoblastic maturation with dyserythropoiesis. The myeloid and megakaryocytic series were unremarkable. The plasma cells were increased in number (20%); however, no immature forms were seen. No granulomas, fungal bodies, or atypical cells were identified. Small foci of necrosis were seen [Figure 1] which were strongly positive for acid-fast Bacilli [Figure 2]. A diagnosis of tuberculosis of bone marrow was given. [1] The patient was started on antiretroviral and antitubercular treatment. Serum protein electrophoresis was performed in view of increased plasma cells [Figure 3], but it did not show any abnormal band. | Figure 1: Bone marrow aspirate - necrotic fragment with many neutrophils and debris (Giemsa stain, ×400)
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 | Figure 2: Bone marrow - numerous acid-fast Bacilli (acid-fast stain, ×1000)
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 | Figure 3: Bone marrow aspirate - plasma cells increased in number (Giemsa stain, ×400)
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Financial Support and Sponsorship
Nil.
Conflicts of Interest
There are no conflicts of interest.
| References | |  |
| 1. | Sen R, Singh S, Singh HP, Sen J, Yadav MS, Arora BR. Demonstration of acid-fast Bacilli in buffy coat and bone marrow smear - A diagnostic tool in pulmonary tuberculosis. J Indian Med Assoc 1996;94:379-80, 390.  |
[Figure 1], [Figure 2], [Figure 3]
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