Cassie, I have the report of your bone marrow biopsy. I cut and pasted this into this e-mail message for you. The bone marrow showed absent iron stores but was otherwise normal. No evidence of marrow necrosis, myelodysplasia, hemophagocytosis, bone marrow infection or malignancy, and nothing really to indicate inflammation or osteomyelitis. This was a very difficult bone marrow for me to perform - I had to try 4 times to try to get in to the bone and aspirate marrow - finally I gave up, obtained a bone biopsy (also very difficult because of strong bone) - and after getting the biopsy I was able to aspirate marrow from that bone marrow biopsy site. I thought we might find something because the bone was so hard to penetrate. I am not sure why this was the case, except that this was the side where you have sacroiliitis and the inflammation from the sacroliac joint might be causing the bone to be very hard in this area. I am not surprised that this was more painful afterwards - based on what I had to do to you to get this bone out, I was very thankful that you were completely out for this. I would anticipate that you may have pain at the bone marrow biopsy site for a couple of weeks afterward. The lump that you feel is probably a hematoma - you did bleed from the biopsy site, though the bleeding stopped quickly. Nevertheless, you may have a lump that you can feel there for even a couple of months afterward. Your bone marrow cultures will be held in the laboratory for up to 6 weeks before they are finalized. So far, they are showing no growth. So, the one thing I can definitely say is that you have extremely strong bone tissue, and you are low on iron, Cassie. I hope that you will make a steady recovery from the biopsy, and am very sorry that you are having so much discomfort. It sounds like you have plenty of pain medication available to handle this. Let me know if that is not the case, and we can work with Dr. Hammell to provide sufficient extra pain medicine for your needs. JPF +++++++++++++++++++++++ BONE MARROW REPORT MATERIAL: Peripheral blood smear, bone marrow aspirate, clot and core biopsy. HISTORY: 28-year-old female with history of anemia. PERIPHERAL SMEAR: RED BLOOD CELLS: There is a moderate macrocytic anemia. WHITE BLOOD CELLS: The white blood cells are normal in number and morphology. PLATELETS: The platelets are normal in number and morphology. BONE MARROW ASPIRATE, CLOT AND CORE BIOPSY: Specimen Adequacy: Adequate Cellularity: 80% M:E Ratio: 3:1 Erythroid Elements: The erythroid elements are normal in number, maturation and morphology. Myeloid Elements: The myeloid elements are normal in number, maturation and morphology. There is no increase in blasts. Megakaryocytes: The megakaryocytes are normal in number and morphology. Lymphocytes and Plasma Cells: The lymphocytes and plasma cells are unremarkable. There is no evidence of lymphoma. Iron Stores (Prussian blue stain): No iron stores are seen. Other: No tumor infiltration, granuloma or necrosis is seen. Bony trabeculae are unremarkable. DIAGNOSIS: - Normocellular bone marrow with normal trilineage hematopoiesis. - The iron stores are absent.
Posted on: Tue, 18 Nov 2014 01:03:20 +0000
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