Bone Marrow Necrosis During Chemotherapy for Lymphoma

ANTEMORTEM diagnosis of bone marrow necrosis was recently reported by Kiraly and Wheby.1The major underlying diseases associated with bone marrow necrosis are sickle cell anemia and malignant neoplasms.1,2Malignant lymphoma has been a particularly uncommon reported cause of bone marrow necrosis.1,3Necrosis as a consequence of intensive chemotherapy has been reported less frequently.1,2We report the case of a patient with poorly differentiated lymphocytic lymphoma involving the bone marrow, in whom striking bone marrow necrosis developed, verified during life by aspiration and biopsy after one month of intensive chemotherapy. Report of a Case A 50-year-old man had severe right leg pain that had been unresponsive to symptomatic treatment. He had lost 10 kg in one month, but did not have fever or night sweats. On admission to George Washington University Medical Center, he appeared chronically ill with right-quadriceps atrophy. No lymphadenopathy, organomegaly, or bony tenderness