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Indian Journal of Pathology and Microbiology
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CASE REPORT
Year : 2020  |  Volume : 63  |  Issue : 2  |  Page : 315-318

Granuloma in marrow with lurking “Leuk”: Two happenstances


1 Department of Pathology, First Floor, Light House Hill Road, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
2 Department of Medicine, Consultant Hematologist, Kasturba Medical College Hospital, Attavara, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

Correspondence Address:
Sridevi Hanaganahalli Basavaiah
Department of Pathology, First Floor, Light House Hill Road, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPM.IJPM_96_19

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Granulomas are described very rarely in marrow biopsies. They have hardly been reported in association with acute lymphoblastic leukemia. We herein report two cases of ALL associated with granulomas each at different stage of their clinical course that led to a diagnostic and therapeutic dilemma. First case was of a 42-year-old woman diagnosed with tuberculosis who presented with bleeding gums during anti-tubercular therapy. In the second scenario, a 51-year-old man presented with pyrexia of unknown origin and splenomegaly who was put on a trial of ATT. Peripheral smear showed only 1–2% abnormal cells, however, bone marrow aspiration and flow cytometry pattern was diagnostic of ALL. Both the patients received chemotherapy and have been on remission so far. These case scenarios put forward a relevant question on this rare coexistence, as the implications on management are manifold.


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