BONE-MARROW NECROSIS

Bone marrow necrosis is most frequently diagnosed at postmortem examin ation. Antemortem diagnosis is still uncommon. In a recent review of w orld literature, we have found 133 cases of bone marrow necrosis diagn osed during life. It has been observed during the course of a wide var iety of diseases, most commonly in association with acute and chronic leukemia, carcinoma, malignant lymphoma, infections, and sickle cell d isease. We report two intravitally diagnosed cases of bone marrow necr osis occurring in two patients with high-grade B-cell lymphoproliferat ive disease. These cases are unusual in that both patients had a triad of bone marrow necrosis, high-grade B-cell lymphoproliferative diseas e, and hypercalcemia. Despite chemotherapy, both cases ultimately prov ed fatal, with progressive involvement of the central nervous system. (C) 1994 Wiley-Liss, Inc.