Bone Marrow Examination for Unexplained Cytopenias Reveals Nonspecific Findings in Patients With Collagen Vascular Disease.

Context.-Collagen vascular diseases are frequently included in the differential diagnosis for unexplained cytopenias and often prompt a bone marrow biopsy in this patient population to exclude malignancy. Few large-scale studies have characterized the bone marrow morphology in patients with collagen...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 137; no. 7; pp. 948 - 955
Autores principales: Hunt, Kristin E., Salama, Mohamed E., Sever, Cordelia E., Foucar, Kathryn
Formato: pictorial research tables/charts Journal Article
Publicado: College of American Pathologists Jul2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: College of American Pathologists
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        atl: Bone Marrow Examination for Unexplained Cytopenias Reveals Nonspecific Findings in Patients With Collagen Vascular Disease.
      aug:
        au:
          Hunt, Kristin E.
          Salama, Mohamed E.
          Sever, Cordelia E.
          Foucar, Kathryn
        affil: Department of Pathology & Laboratory Medicine, Henry Ford Hospital, Detroit, MI
      sug:
        subj:
          Bone Marrow Examination
          Hematologic Diseases Diagnosis
          Connective Tissue Diseases Diagnosis
          Blood Cell Count
          Bone Marrow Pathology
          Immunohistochemistry
          Comparative Studies
          Prospective Studies
          Analysis of Variance
          Chi Square Test
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Female
          Male
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Context.-Collagen vascular diseases are frequently included in the differential diagnosis for unexplained cytopenias and often prompt a bone marrow biopsy in this patient population to exclude malignancy. Few large-scale studies have characterized the bone marrow morphology in patients with collagen vascular disease, and most are limited to systemic lupus erythematosus or rheumatoid arthritis. Objective.-To identify morphologic and immunohistochemical abnormalities specific to each of a wide range of collagen vascular disease cases. Design.-We examined 102 cases of collagen vascular disease and 38 controls and evaluated the complete blood count, peripheral blood morphology, bone marrow morphology, as well as immunohistochemical staining, for numerous cell lineages. Results.-Bone marrow findings, including abnormalities such as lymphoid aggregates, lipogranulomas, or abnormal localization of immature precursors, were not significantly different as compared to the control group. Conclusions.-Bone marrow examination in patients with collagen vascular disease with cytopenias seldom provides new information. Caution should be exercised in interpreting morphologic findings suggestive of myelodysplasiasince these are of a reactive nature in up to 27% of patients with collagen vascular disease. In a cost-effective diagnostic strategy, successful utilization may favor postponing a bone marrow biopsy while a more standardized autoimmune diagnostic panel is being performed.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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