Myelofibrosis associated with tuberculosis; a report of four cases.

Myelofibrosis (fibrotic bone marrow and, usually, an increase in megakaryocytes) is characterized by generalized pains, weakness, loss of weight, enlargement of the liver and spleen and a leuko-erythroblastic anemia. Four cases of myelofibrosis associated with generalized tuberculosis have been reviewed in detail. Autopsy examination of the 4 cases revealed acute, caseating tuberculosis which was considered to be responsible for the bone marrow and generalized fibrosis observed. A similar type of tuberculosis occurred in 7 of 91 cases of myelofibrosis reveiwed in the literature. The pathogenesis of myelofibrosis associated with tuberculosis is discussed. In the diagnosis of this syndrome, attention is called to the importance of obtaining a bone marrow biopsy and making a complete bacteriologic and pathologic study of this tissue for tuberculosis. The 4 tuberculous cases here reported as compared with 5 cases of idiopathic type, are younger, have hyperpyrexia, less splenic but greater lymph node enlargement and run a shorter course before death.