Open AccessGranuloma in marrow with lurking “Leuk”: Two happenstances
Author(s) -
Saraswathy Sreeram,
Sridevi Hanaganahalli Basavaiah,
Nirupama Murali,
Prashantha Balanthimogru
Publication year - 2020
Publication title -
indian journal of pathology and microbiology/indian journal of pathology and microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.217
H-Index - 31
eISSN - 0974-5130
pISSN - 0377-4929
DOI - 10.4103/ijpm.ijpm_96_19
Subject(s) - medicine , bone marrow , pathology , tuberculosis , bone marrow aspirate , granuloma , stage (stratigraphy) , dermatology , paleontology , biology
Granulomas are described very rarely in marrow biopsies. They have hardly been reported in association with acute lymphoblastic leukemia. We herein report two cases of ALL associated with granulomas each at different stage of their clinical course that led to a diagnostic and therapeutic dilemma. First case was of a 42-year-old woman diagnosed with tuberculosis who presented with bleeding gums during anti-tubercular therapy. In the second scenario, a 51-year-old man presented with pyrexia of unknown origin and splenomegaly who was put on a trial of ATT. Peripheral smear showed only 1-2% abnormal cells, however, bone marrow aspiration and flow cytometry pattern was diagnostic of ALL. Both the patients received chemotherapy and have been on remission so far. These case scenarios put forward a relevant question on this rare coexistence, as the implications on management are manifold.