Bone Marrow Granuloma

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Bone Marrow Granuloma

#00065604

Author: Dr Anupama Patil
Category: Reactive Marrow > Reactive changes > Histiocytes > Granulomas
Published Date: 03/28/2025

A 63-year old male patient, a known case of bullous pemphigoid on immunosuppresive therapy, presented with fever and cytopenias. Serological testing revealed IgM positivity for cytomegalovirus (CMV).

Bone marrow biopsy showed granulomatous inflammation. Multiple discrete granulomas were identified. Ziehl-Neelsen stain, Periodic Acid-Schiff stain, and Grocott’s Methenamine Silver (GMS) stain were all negative.

Further evaluation with CMV PCR, serum QuantiFERON-TB Gold, and fungal cultures was recommended.

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