Navigating the enigma of bone marrow granulomas: A case series exploration

Abstract

  Introduction: Granulomatous diseases of marrow can result from a varied group of disorders ranging from infectious diseases to hematological malignancies. Finding granuloma in bone marrow biopsy is a rare finding. Detection of granulomatous disease is possible on Bone marrow biopsy and sometimes it changes the treatment modality. Aims and Objectives: To study incidence and etiologies of granulomatous diseases of marrow. Materials and Methods: This was a retrospective study conducted in Department of Pathology, M.K.C.G. Medical College and Hospital, Berhampur. Bone marrow biopsy performed in the period of 1st January 2021 to 31st December 2022were reviewed along with medical records of these patients. Results: We reviewed 185 cases of Bone marrow biopsy confirming presence of granuloma in ten patients. The age of the patients varied from 5 years to 55 years. Out of the 10 cases seven (70%) had history of fever, two (20%) with history of pain in abdomen and loss of appetite and (10%) one with weakness. Eight (80%) out of the ten cases had organomegaly. CBC and peripheral smear evaluation of all the cases were done and the finding was pancytopenia in six (60%) cases followed by bicytopenia in four (40%). Seven out of the 10 cases were diagnosed as case of Tuberculosis, one as Hogdkin’s Lymphoma one as Sarcoidosis in Bone marrow trephine biopsy. Despite of thorough investigations no definite etiology was detected in one case. Conclusion: Bone marrow trephine biopsy is very helpful in finding out Granuloma which is though a non-specific finding may narrow down the diagnosis to various possible differentials.