Korean J Clin Pathol.  1999 Apr;19(2):172-176.

A Case of Bone Marrow Necrosis Preceeding Acute Monoblastic Leukemia

• Jeong GY
• Yoon HR
• Kim SH

Abstract

Bone marrow necrosis is rarely diagnosed during life but is more often seen at autopsy by accident. The prognosis of patients with bone marrow necrosis secondary to neoplastic disease is extremely poor. We experienced a 59-year-old man with acute monoblastic leukemia who developed bone marrow necrosis preceding leukemia. He's main complaint was continuous lower back pain. First hematologic examination showed anemia with leukopenia and extensive bone marrow necrosis. After suffering from sepsis and only supportive management, he spontaneously recovered from pancytopenia and achieved hypercellular marrow with trilineage hematopoiesis. After 6 months, he was diagnosed as acute monoblastic leukemia (FAB, AML, M5a) from the sudden appearence of leukemic blasts on peripheral blood smears. After induction chemotherapy, complete remission was achieved. Our experience suggests that bone marrow necrosis is not uncommonly associated with hematologic malignancy and occult cancer. When bone marrow necrosis is found, we should do close follow-up to find out underlying hidden malignancy.

Keyword

Bone marrow necrosis; acute monoblastic leukemia (FAB, AML, M5a)

MeSH Terms

Anemia
Autopsy
Bone Marrow*
Follow-Up Studies
Hematologic Neoplasms
Hematopoiesis
Humans
Induction Chemotherapy
Leukemia
Leukemia, Monocytic, Acute*
Leukopenia
Low Back Pain
Middle Aged
Necrosis*
Pancytopenia
Prognosis
Sepsis