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Massive bone marrow necrosis revealing an HIV-related primary bone marrow lymphoma: a diagnostic challenge

  • Michael D. Diamantidis
  • Vasiliki Gogou
  • Triantafyllia Koletsa
  • Simeon Metallidis
  • Maria Papaioannou
Case Report

Abstract

Bone marrow necrosis (BMN) is a condition that can be difficult to diagnose, requiring a hematologist experienced in bone marrow morphology. This diagnostic challenge should alert the clinician of a severe disease or a possible underlying malignancy, either hematological or a solid tumor. We describe the concomitant presence of a primary bone marrow lymphoma (diffuse large B-cell lymphoma—DLBCL), along with an extensive BMN in an HIV patient for the first time in a living individual. HIV infection, BMN and DLBCL presented a multifactorial crossword of molecular events underlying the complex pathophysiology. The exact precipitating pathophysiological events resulting in BMN remain obscure and provide their clear impact for future research. The present report is instructive and also contains a critical review of the literature related to the case presented.

Keywords

Bone marrow necrosis (BMN) Human immunodeficiency virus (HIV) Primary bone marrow lymphoma Diffuse large B-cell lymphoma (DLBCL) Dismal prognosis 

Notes

Author contributions

MDD analyzed and interpreted data, performed literature review and wrote the manuscript; VG treated the patient, analyzed and interpreted data; TK analyzed and interpreted data and provided the pathology images of the bone marrow; SM treated the patient, performed literature review, analyzed and interpreted data; MP wrote and corrected the manuscript, was in charge of the overall study, diagnosed the bone marrow necrosis in the aspirate, treated the patient, analyzed and interpreted data and performed literature review.

Compliance with ethical standards

Conflict of interest

All authors declare they have no conflict of interest.

Informed consent

Because the case of a deceased patient is described, written informed consent from a close relative has been obtained.

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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  1. 1.Department of Haematology, First Department of Internal Medicine, Faculty of Medicine, AHEPA General HospitalAristotle University of Thessaloniki (AUTH)ThessalonikiGreece
  2. 2.Department of Pathology, Faculty of Medicine, AHEPA General HospitalAristotle University of Thessaloniki (AUTH)ThessalonikiGreece

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