Abstract
We report a case of acute myelofibrosis (AMF), whose bone marrow fibrosis had almost disappeared on autopsy following chemotherapy. Fourty five-year-old male was admitted to Jichi Medical School Hospital on April 2, 1983, because of fever and a tumor in his left hip. He was diagnosed as having AMF by the following clinicopathologic manifestations; rapidly progressive pancytopenia, a few blasts in peripheral blood identified as megakaryocytic series by the platelet peroxidase reaction (PPO), absence of abnormal red cell morphology, lack of splenomegaly, and diffuse bone marrow fibrosis with relative proliferation of atypical immature megakaryocytic cells on bone marrow biopsy. the tumor in his hip was histologically identified as inflammatory reaction without atypical cells.
He was treated with cytosine arabinoside and daunorubicin. After 20 days, diminution of bone marrow fibrosis and disappearance of atypical immature megakaryocytic cells was observed on bone marrow biopsy. However, the patient did not obtain hematological improvement, and died on June 13, 1983.
Post-mortem examination disclosed that there were no extramedullary hematopoietic foci and atypical cells in the liver (2,070 g) and spleen (230 g), marked diminution of bone marrow fibrosis and disappearance of atypical immature megakaryocytic cells, suggesting that bone marrow fibrosis of AMF is reversible following chemotherapy.
