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IS BONE MARROW TUBERCULOSIS AN ENTITY?
OP Kapoor
Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
In many cases of PUO, all the tests are normal. Quite often, I have come across patients where bone marrow aspiration has not contributed to the diagnosis. I then ask for bone marrow biopsy. Off and on, I am rewarded by the diagnosis of tuberculosis.
Although, this type of haematogenous tuberculosis can possibly be picked up by liver and spleen biopsies as well, but marrow biopsy remains the easiest method.
It is time that the doctors should realise that bone tuberculosis is not the same as marrow tuberculosis. Tuberculosis of the spine is a good example of the former condition.
So often, I have seen that even if the marrow biopsy was normal, a repeat bone marrow biopsy by a senior doctor having a bigger needle brings out the diagnosis and can differentiate between tuberculosis and lymphoma.
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