Gelatinous transformation of bone marrow: a rare cause of pancytopenia
Keywords:
Gelatinous marrow transformation, serous atrophy, pancytopenia, protein energy malnutrition
Abstract
Gelatinous marrow transformation (GMT) also known as serous atrophy is a very rare entity characterized by fat cell atrophy, accumulation of extracellular gelatinous material in the bone marrow and adjacent marrow hypoplasia. This morphologically defined condition is non specific and can be seen in many hematological and non hematological conditions. Hence, appropriate identification and management of underlying etiology is important. Mostly seen in adult patients and very few cases are reported in pediatric age group.We describe two cases of pediatric age group who presented with pancytopenia. First was a case of protein energy malnutrition and underlying chronic liver disease. Second was a case of disseminated tuberculosis. On bone marrow aspiration both showed fat cell atrophy, marrow hypoplasia and accumulation of extracellular eosinophilic material which was PAS positive suggestive of gelatinous transformation of bone marrow. Our case report adds to the existing literature on gelatinous marrow transformation diagnosed on bone marrow aspiration study. It also suggests that this condition should be looked for as a cause of pancytopenia.References
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10. Das S, Mishra P, Kar R, Basu D Gelatinous Marrow Transformation: A Series of 11 Cases from a Tertiary Care Centre in South India. Turk J Haematol. 2014; 31(2): 175–179
2. Cornbleet PJ, Moir RC, Wolf PL. A histochemical study of bone marrow hypoplasia in anorexia nervosa. Virchows Arch (Pathol Anat) 1977; 374:239–247.
3. Jain R, Singh ZN, Khurana N, singh T. Gelatinous transformation of bone marrow: a study of 43 cases. Ind J Pathol Microbiol. 2005;48:1-3
4. Basu S, Mitra S. Gelatinous transformation of bone marrow. Ind J Pathol Microbiol 1997;40:383-384
5. Meheta K, Gascon P, Robboy S. The gelatinous bone marrow (serous atrophy) in patients with acquired immunodeficiency syndrome Evidence of excess sulfated glycosaminoglycan. Arch Pathol Lab Med.1992; 116:504–8.
6. Seaman JP, Kjeldsberg CR, Linker A. Gelatinous transformation of the bone marrow. Hum Pathol. 1978; 9:685–692.
7. Wang C, Amato D, Fernandes B. Gelatinous transformation of bone marrow from a starch-free diet. Am J Hematol. 2001; 68:58–59.
8. Sen R, Singh S, Singh H, Gupta A, Sen J. Clinical profile in gelatinous bone marrow transformation. J Assoc Physicians India. 2003;51:585–588. [pubmed]
9. Chen SH, Hung IJ, Jaing TH, Sun CF. Gelatinous degeneration of the bone marrow in anorexia nervosa. Chang Gung Med J. 2004;27:845–849.
10. Das S, Mishra P, Kar R, Basu D Gelatinous Marrow Transformation: A Series of 11 Cases from a Tertiary Care Centre in South India. Turk J Haematol. 2014; 31(2): 175–179
Published
2015-05-10
Issue
Section
Case Report
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