A large number of conditions can result in granulomas within the bone marrow. Sometimes granulomas are incidental but at other times evidence of a disseminated disease.
Patient selection: granulomas in the bone marrow
Differential diagnosis:
(1) malignant neoplasms
(2) infection
(3) drugs
(4) foreign bodies
(5) rheumatologic disorders
(6) sarcoidosis
(7) idiopathic
Neoplasms associated with bone marrow granulomas:
(1) malignant lymphoma (Hodgkin's disease, non-Hodgkin's)
(2) acute leukemia (lymphocytic, myelogenous)
(3) chronic leukemia
(4) myeloma
(5) malignant histiocytosis
(6) myelodysplastic syndrome (MDS)
(7) carcinomas (lung, colon, neuroblastoma, other)
(8) sarcoma
Infections associated with bone marrow granulomas:
(1) mycobacterial infection, including BCG and leprosy
(2) deep fungal infection (Histoplasmosis, etc)
(3) Q fever
(4) brucellosis
(5) typhoid fever
(6) tularemia
(7) mycoplasma
(8) rickettsiosis
(9) syphilis
(10) opportunistic fungal infection
(11) virus (EBV, CMV, HIV, HCV, HSV)
Drugs associated with bone marrow granulomas:
(1) procainamide
(2) sulfonamides
(3) chlorpropamide
(4) phenylbutazone
(5) phenytoin
(6) methyldopa
(7) allopurinol
(8) ibuprofen
(9) penicillamine
(10) tolmetin sodium
Rheumatologic disorders associated with bone marrow granulomas:
(1) rheumatoid arthritis (RA)
(2) systemic lupus erythematosus
(3) temporal arteritis
(4) Sjogren's syndrome
(5) primary biliary cirrhosis (PBC)
(6) erythema nodosum
(7) Behcet's disease
(8) autoimmune hemolytic anemia
Specialty: Hematology Oncology, Clinical Laboratory