Gelatinous marrow transformation (GMT) refers to a histologic change seen in the bone marrow that is associated with a number of conditions.


Synonym: gelatinous degeneration


Histologic features of GMT:

(1) deposition of an extracellular gelatinous substance in the bone medullary space. This material is rich in hyaluronic acid and glycosaminoglycan (mucopolysaccharides). The material stains positively with Alcian blue stain at pH 2.5.

(2) focal loss of hematopoietic cells

(3) fat cell atrophy


Conditions associated with GMT:

(1) starvation and malnutrition, including anorexia nervosa, AIDS, cancer and cachexia

(2) acute systemic febrile illness

(3) visceral leishmaniasis

(4) systemic lupus erythematosus (SLE)

(5) alcoholism

(6) heart failure


Successful treatment of the cause can cause the GMT to reverse and even disappear.


Differential diagnosis:

(1) amyloid

(2) fibrinoid necrosis following chemotherapy

(3) edema


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