Histoplasmosis on bone marrow aspirate cytological examination associated with hemophagocytosis and pancytopenia in an AIDS patient.

The Korean Journal of Hematology Pub Date : 2012-03-01 Epub Date: 2012-03-28 DOI:10.5045/kjh.2012.47.1.77
Harish Chandra, Smita Chandra, Anita Sharma
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引用次数: 19

Abstract

A 38-year-old woman who presented with unexplained fever and pancytopenia was subjected to a bone marrow examination. Her bone marrow aspirate smear showed no obvious pathological finding except for the presence of hemophagocytosis and mild plasmacytosis. In view of hemophagocytosis, a thorough examination of the smear was conducted and revealed the presence of histoplasmosis. She was advised to undergo evaluation of her immunological status, and she tested positive for human immunodeficiency virus (HIV) infection. This case highlights that hemophagocytosis in the marrow may be an early sign of underlying disease, and that careful examination of bone marrow smears may reveal subtle infections. In addition, histoplasmosis with hemophagocytosis may be associated with pancytopenia, and hence, the HIV status of the patient should always be investigated.

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1例艾滋病患者骨髓抽吸细胞学检查中组织胞浆菌病伴噬血细胞症和全血细胞减少症。
一位38岁的女性,出现不明原因的发热和全血细胞减少症,接受了骨髓检查。骨髓涂片除噬血及轻度浆细胞增多外,未见明显病理表现。考虑到噬血细胞症,对涂片进行了彻底的检查,发现组织浆菌病的存在。医生建议她接受免疫状况评估,结果她的人类免疫缺陷病毒(HIV)感染检测呈阳性。本病例强调骨髓噬血细胞增多可能是潜在疾病的早期征兆,仔细检查骨髓涂片可能会发现细微的感染。此外,组织浆菌病伴噬血细胞症可能与全血细胞减少症有关,因此,应始终调查患者的HIV状态。
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