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Osteo myelo fibrosis osteo myelo sclerosis a histological and cyto genetic study on core biopsies of the bone marrow



Osteo myelo fibrosis osteo myelo sclerosis a histological and cyto genetic study on core biopsies of the bone marrow



Virchows Archiv A Pathological Anatomy & Histology 389(3): 269-286



A combined histological and cytogenetic study was performed on the bone marrow in 33 patients with overt osteomyelofibrosis/-sclerosis (MF/OMS) and agnogenic myeloid metaplasia including blast crisis. Histopathology of samples of bone marrow showed an abnormal proliferation of megakaryopoiesis with conspicuous atypias of growth and maturation in addition to a neoplastic neutrophilic granulopoiesis, particularly in the early stages of MF. A biphasic population of neoplastic hematopoiesis is postulated and this lesion is called chronic megakaryocytic-granulocytic myelosis (CMGM) with myelofibrosis-CMGM stage III, or with osteomyelosclerosis, CMGM stage IV. Cytogenetic evaluation demonstrated the Philadelphia (Ph') chromosome in 93% of CGL and in 67% of MF/OMS, including cases with blast crisis. Unlike CGL and MF/OMS where a Ph' chromosome is common, myelofibrosis of non-neoplastic origin and AML displayed no Ph' chromosome. Further aberrations such as aneuploidy involved the C/D group chromosomes predominantly and were especially prominent in blast crisis with no significant differences in CGL and MF/OMS or in AML. Chromosomal analysis showed no fundamental differences between CGL and myeloproliferative disorders of mixed cellularity, i.e., chronic megakaryocytic-granulocytic myelosis (CMGM). The terminal stages of fibrotic and osteosclerotic lesions belong in these categories of CMGM or CCL, respectively. MF/OMS are final stages or subtypes of CML, carrying the same chromosomal marker and demonstrating remarkable atypias of the hematopoietic tissue suggestive of malignancy. The fibrotic/osteosclerotic alteration is thought to represent a secondary non-neoplastic feature.

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