Bone marrow granulomas in a high tuberculosis prevalence setting

Yu Wang, Xiao Yan Tang, Ji Yuan, Shou Quan Wu, Guo Chen, Miao Miao Zhang, Ming Gui Wang, Wen Yan Zhang, Jian Qing He

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Granulomas were reported in 0.3% to 3% of bone marrow biopsies. The aim of the study was to evaluate the incidence and etiology of bone marrow granulomas (BMGs) in the West China Hospital, which located at a high tuberculosis (TB) prevalence area in China. A retrospective case review was performed on 11,339 bone marrow biopsies at the West China Hospital of Sichuan University between January 2011 and December 2015. Cases with BMGs were retrieved and their clinical data and histopathological features were collected, examined, and analyzed. Out of 11,339, 110 cases showed granulomatous lesions in the bone marrow biopsies (0.97%). Etiologies were indentified in 80 cases (72.8%), with infections being the most common (64.5%), following by malignancies (4.5%) and autoimmune diseases (3.6%). Among infectious cases, 87.32% (62/71) cases were diagnosed as TB, a positive acid-fast stain or/and polymerase chain reaction (PCR) result for mycobacterium TB DNA fragment amplification was obtained for 35 cases. In 30 cases (27.27%), a definite diagnosis could not be established. In a TB high prevalence region in China, with a combined histological, clinical, serological, and molecular approach, we were able to clarify the cause in 72.73% of the bone marrow granulomatous cases. TB is the most common underlying etiologies. Therefore, acid-fast stain and quantitative PCR for mycobacterium TB DNA amplification are recommended as a routine for bone marrow biopsies in TB high prevalence regions.

Original languageEnglish (US)
Article numbere9726
JournalMedicine (United States)
Volume97
Issue number4
DOIs
StatePublished - Jan 1 2018

Keywords

  • biopsy
  • bone marrow
  • granulomas
  • prevalence
  • tuberculosis

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Wang, Y., Tang, X. Y., Yuan, J., Wu, S. Q., Chen, G., Zhang, M. M., Wang, M. G., Zhang, W. Y., & He, J. Q. (2018). Bone marrow granulomas in a high tuberculosis prevalence setting. Medicine (United States), 97(4), [e9726]. https://doi.org/10.1097/MD.0000000000009726