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Colegio de Medicina Interna de México.

2021, Number 3

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Med Int Mex 2021; 37 (3)

Bone marrow necrosis: sign of malignity

Aguilar-Hidalgo JA, Duarte-Mote J, Ezeta-Monroy ME, Serdán-Gutiérrez R, Gómez-Hernández L, Gutiérrez-Alvarado DA, Ulloa-García JC, Gutiérrez-Juárez KG

Language: Spanish
References: 23
Page: 430-437
PDF size: 375.38 Kb.


ABSTRACT

Background: Bone marrow necrosis is characterized by necrosis of myeloid tissue and medullary stroma, with alteration of normal morphology and preservation of cortical bone. The incidence of this disease is extremely rare, occurring in 0.3% to 37% depending on whether the diagnosis is premortem or postmortem. It was first described in 1942 in a patient with sickle cell anemia, postmortem. Due to its important relationship with neoplastic origin, hematologic malignancies and metastatic solid tumors comprise up to 90% of all causes. Solid neoplasms are presented in 40% of cases, being the most frequent gastric adenocarcinoma. The main clinical manifestations are bone pain usually located in the lumbar region, being a frequent cause of hospitalization; fever, anemic syndrome, and hemorrhage.
Clinical case: A 55-year-old male patient who attend to the clinic for chronic low back pain and hemorrhagic syndrome, in whom bone marrow necrosis was diagnosed.
Conclusions: Diagnosis is based on pathological study and characteristic data on magnetic resonance image. An important complication is embolic phenomena. Definitive treatment is based on managing the underlying disease.


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