Granuloma whorls

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Peripheral cytopenias necessitate thorough investigation to determine underlying causes.
• Bone marrow examination remains a cornerstone in diagnosing hematological malignancies and other systemic diseases.

Purpose of the Study:

• To evaluate the diagnostic significance of bone marrow examination in cases of unexplained peripheral cytopenias.
• To highlight the potential of bone marrow biopsy in identifying non-hematological conditions.

Main Methods:

• Bone marrow trephine biopsy was performed.
• Histopathological examination of the bone marrow sample was conducted.

Main Results:

• The bone marrow trephine initially performed for exclusion of Idiopathic Thrombocytopenic Purpura (ITP) revealed non-specific findings.
• Subsequent examination identified multiple granulomas, strongly suggesting Mycobacterium tuberculosis infection.

Conclusions:

• Bone marrow examination is indispensable for diagnosing hematological disorders and can also reveal infections like tuberculosis.
• This case underscores the importance of considering infectious etiologies in the differential diagnosis of cytopenias, even when initially investigated for hematological conditions.