The clinical significance of histopathology of marrow-containing bone

Abstract

The material of the present collection of illustrations derives from myelotomies which were carried out on request of the attending physicians for the elucidation of diagnostic problems and from a small number of samples from volunteers. This proves that histopathology of marrow-containing bone is of interest initially to the clinician as a practical diagnostic means. This interest refers on the one hand to structural changes typical of a certain disease, and on the other hand to those which reveal secondary disorders in the organ examined. These may in turn contribute to the main diagnosis either by exclusion or by confirmation, their importance may even surpass those of the main diagnosis. The first applies if for instance the typical changes of Hodgkin’s disease are detected in the bone marrow in high fever with unspecific blood findings and normal organs—or if the bone marrow vessels show the changes of hypersensitivity angiitis in a clinical picture of acute nephritis—or if osteomalacia proves to be the real reason for a wrongly diagnosed disturbance of gait in a neurotic female patient. The second applies if for instance the marrow has disappeared due to chemotherapy but still shows miliary tubercles; the pancytopenia could however be caused by an inflammatory marrow fibrosis.