Pathology
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Atlas of Bone Marrow pathology
Mojmir Moulis, Josef Feit et al.
Index
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+ Introduction
+ Using this atlas
+ Conditions of using this atlas
+ Technical notes
+ Hardware
+ Software
+ How to use the atlas
+ Navigating through the text pages
+ Controlling the pictures
+ Logos and labels
+ What will you need to use the atlas
+ Bugs, problems
+ Netscape
+ Microsoft Internet Explorer
+ Some other Internet resources concerning dermatopathology and pathology
+ Support
+ Support
+ Bone Marrow Pathology
+ Bone Marrow Examination
+ Bone Marrow Examination
+ Histological evaluation of the trephine biopsy core
+ Normal bone marrow
+ Bone Marrow Cellularity
+ Hematopoiesis
+ Non-tumorous Lesions of Bone Marrow
+ Reactive Hematopoietic Changes
+ Erythroid hyperplasia
+ Myeloid Hyperplasia
+ Eosinophilia
+ Increased Number of Megakaryocytes
+ Bone Marrow Hypoplasia and Aplasia
+ Aplastic Anemia
+ Pure red cell aplasia
+ Agranulocytosis
+ Amegakaryocytic thrombocytopenia
+ Anemias
+ Posthemorrhagic anemias
+ Acute Posthemorrhagic Anemia
+ Chronic Posthemorrhagic Anemia
+ Megaloblastic Anemia
+ Sideropenic Anemia
+ Chronic Kidney Disease Anemia
+ Anemias of Chronic Disorders
+ Hemolytic Anemias
+ Other anemias
+ Stromal Reaction and Bone Marrow Inflammation
+ Reactive lymphocytosis, benign lymphocytic aggregates
+ Reactive Plasmacytosis
+ Granulomas
+ Hemophagocytic Syndrome
+ Storage Diseases (Thesaurismosis)
+ Gaucher's Disease
+ Niemann–Pick Disease
+ Bone marrow tumorus diseases
+ Myelodysplastic Syndrome (MDS)
+ Refractory Cytopenia with Unilineage Dysplasia (RCUD)
+ Refractory Anemia with Ringed Sideroblasts (RARS)
+ Refractory Cytopenia with Multilineage Dysplasia (RCMD)
+ Refractory Anemia with Excess Blats (RAEB)
+ MDS with Isolated 5q Deletion (5q-syndrome)
+ Myelodysplastic Syndrome Unclassified (MDS NOS)
+ Myeloproliferative neoplasms
+ Polycythemia Vera (PV)
+ Essential Thrombocythemia (ET)
+ Primary Myelofibrosis (PMF)
+ Chronic Myeloid Leukemia (CML)
+ Chronic Neutrophilic Leukemia (CNL)
+ Chronic Eosinophilic Leukemia (CEL)
+ Mastocytosis
+ MPN unclassifiable (MPN-U)
+ Myelodysplastic-myeloproliferative diseases (MDS/MPD)
+ Chronic Myelomonocytic Leukemia (CMML)
+ Atypical Chronic Myeloid Leukemia (aCML)
+ Juvenile Myelomonocytic Leukemia (JMML)
+ Myelodysplastic-Myeloproliferative Diseases Unclassifiable
+ Acute Myeloid Leukemia (AML)
+ Lymphoproliferative Disorders
+ Acute Lymphoblastic Leukemia (ALL)
+ Chronic Lymphocytic Leukemia (CLL)
+ Prolymphocytic Leukemia (PLL)
+ Hairy cell leukemia (HCL)
+ Plasma Cell Neoplasms
+ Plasma Cell (Multiple) Myeloma
+ Solitary Plasmocytoma
+ Monoclonal Gammapathy of Undetermined Significance (MGUS)
+ Other Lymphoproliferative Diseases
+ Histiocytoses
+ Histiocytosis X (Langerhans Cell Histiocytosis)
+ Letterer-Siwe Histiocytosis
+ Hand-Schüller-Christian Histiocytosis
+ Eosinophilic Granuloma
+ Histiocytic Sarcoma
+ Metastatic Infiltration of the Bone Marrow
+ Posttheraupetic a Posttransplant Hematopoietic Changes
+ Posttheraupetic Hematopoietic Changes
+ Restitution of Hematopoiesis
+ Persistent Alterations of Hematopoiesis.
+ Posttransplant Alterations of Hematopoiesis
+ Pathology of the Bone
+ Other Disorders
Primary Myelofibrosis (PMF)
Clinical signs
  • proliferation, especially of the magakaryocytic and granulocytic lineages, associated with fibrosis
  • 2 stages:
    • pre-fibrotic/cellular
    • fibrotic
  • early symptoms are non-secific, in later stages symptoms include anemia, organomegaly, subfebrile temperatures, fatigue, weight loss
  • prognosis: median survival time is approx. 3 – 7 years for patients diagnosed in the fibrotic stage and approx. 10 – 15 years for patients diagnosed during the early pre-fibrotic stage, 5 – 30% of patients develop AML
Histology
  • pre-fibrotic stage: hypercellular bone marrow, clusters of increased numbers of large megakaryocytes with hyperlobated nuclei, dysplastic megakaryocytes, a relative increase in granulopoiesis (M : E ratio is approx. 5 : 1), none or only slight fibrosis (MF-0 or MF-1)
  • fibrotic stage: extensive fibrosis of the bone marrow (MF-2 nebo MF-3) with residual hematopoiesis, clusters of dysplastic megakaryocytes, dilatated sinuses with hematopoietic cells, osteosclerosis, extramedullar hematopoiesis
Pictures

Chronic idiopathic myelofibrosis: Chronic idiopathic myelofibrosis, HE 100x (72423) Chronic idiopathic myelofibrosis, HE 100x (72424) Chronic idiopathic myelofibrosis, van Gieson 100x (72425) Chronic idiopathic myelofibrosis, Gömöry 100x (72427)

Another case: Chronic idiopathic myelofibrosis (CIMF), PAS 100x (72887)