Gelatinous transformation of bone marrow: rare or underdiagnosed?

Authors

  • Khushdeep Kaur Shergill Armed Forces Medical College, Department of Pathology
  • Gagandeep Singh Shergill Government Medical College, Department of Medicine
  • Hari Janardanan Pillai Armed Forces Medical College, Department of Surgery

DOI:

https://doi.org/10.4322/acr.2017.039

Keywords:

Bone Marrow Disease, Bone Marrow Examination, Bone Marrow.

Abstract

Gelatinous transformation of the bone marrow (GTBM) is a rare hematologic entity, which was first described by Paul Michael in 1930. GTBM is mostly associated with caloric intake/anorexia nervosa, although it also has been described accompanying other pathologic conditions, such as malignancy, systemic lupus erythematosus and HIV infections. Even though the diagnostic features of the hematopoietic tissue, such as hypoplasia, adipose cell atrophy, and deposition of a gelatinous substance in the bone marrow (which stains with Alcian blue at pH 2.5) are quite specific, the underlying pathogenic mechanisms remain poorly understood. Considering the evidence of reversibility—notably in cases of malnutrition and anorexia—this entity should be kept high on cards as a possible differential diagnosis of patients presenting with cytopenias and associated weight loss or starvation, especially in developing countries with nutritionally deprived populations. On an extensive review of the literature aimed at comprehensively addressing the evolution of the GTBM from the past century until now, we conclude that the lack of clinical suspicion and awareness regarding this pathologic entity has led to misdiagnosis and delayed diagnosis.

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Published

2017-12-12

Issue

Section

Review Article

How to Cite

Gelatinous transformation of bone marrow: rare or underdiagnosed?. (2017). Autopsy and Case Reports, 7(4), 8-17. https://doi.org/10.4322/acr.2017.039