Is it justified to perform a bone marrow biopsy examination in sustained erythrocytosis

摘要: The diagnostic criteria of the Polycythemia Vera Study Group do not consider bone marrow histopathology, nor they recognize dynamics polycythemia vera (PV). Precursor stages, when accompanied by an elevated platelet count, may clinically mimic essential thrombocythemia. Significantly extending former descriptions features, a trilineage myeloproliferation (panmyelosis) with pleomorphous appearance (differences in size) megakaryopoiesis is characteristic histopathologic finding PV. Differentiation from secondary accomplished also considering conspicuously expressed stromal changes (perivascular plasmacytosis, eosinophils, cell debris, and iron deposits). A clear-cut discrimination possible, even initial (latent) stages PV, which fulfill all conventional criteria. Advanced (spent phases) PV show increased left-shifted granulocytic proliferation reduction erythroid precursors progressive myelofibrosis (postpolycythemic myeloid metaplasia). Finally, increase dysplastic immaturity lineages signals transition into blastic crisis.