Gelatinous transformation of bone marrow in a rabbit

A 9-y-old, spayed female rabbit was presented for evaluation of hypoglycemia and lateral recumbency. The patient was hypothermic and had diffuse muscle wasting; weight loss since a previous visit was also noted. Hematologic abnormalities included progressive nonregenerative anemia and severe heteropenia. Evaluation of a bone marrow aspirate sample revealed active hematopoiesis with abundant pink matrix. The matrix material stained positively with periodic acid–Schiff and alcian blue, and a diagnosis of gelatinous transformation of the bone marrow (GTBM, serous atrophy of fat) was made. Although its precise prevalence remains to be determined, GTBM should be suspected in rabbits with persistent cytopenias following prolonged starvation or gastrointestinal disease.

MR Findings in the Bone Marrow of a Patient with Anorexia Nervosa

Gelatinous transformation of bone marrow (GTBM) is a hematological condition found to be associated with states of cachexia and malnourishment, which can be seen in patients with eating disorders, alcoholism, malignancy, and other systemic diseases (such as AIDS, tuberculosis, chronic kidney disease, and chronic heart failure). GTBM is not disease-specific but is a good marker of a severe underlying disease. Initially thought to be a rare finding, newer literature is now demonstrating more cases of GTBM over the past 2 decades, and the alleged rarity may have been attributed to the lack of clinical suspicion and awareness of this condition. We present a case of a young adult female, who has a background of anorexia nervosa and presented with a 4-month history of pain over her left shin. Magnetic resonance imaging (MRI) of the tibia demonstrated the gelatinous transformation of the bone marrow. In this case report, we aim to highlight the underlying pathogenesis of GTBM and its prevalence, its unique distribution within the marrow, its characteristic MRI findings, and how these findings may differ in comparison to normal reconversion marrow and neoplastic infiltration.

Gelatinous Transformation of Bone Marrow in the Calcaneus, Diagnosed by Open Bone Biopsy in a Patient With Anorexia Nervosa

Gelatinous transformation of bone marrow (GTBM) is a complication of various diseases, one of which is anorexia nervosa (AN). We describe a rare case of a 20-year-old man who presented to our clinic with a 3-month history of heel pain without trauma. At presentation, he was noted to have a low body mass index (BMI) of 16.2 kg/m2 and pancytopenia. On magnetic resonance imaging, the left calcaneus showed low intensity on T1-weighted and high intensity on T2-weighted images. Open biopsy was done because we suspected that the lesion was either a lymphoproliferative tumor or a trabecular-type bone metastatic tumor. However, tissue histology of bone samples showed atrophy of fat cells with deposition of gelatinous material and a decreased hematopoietic cell population. Therefore, we made a diagnosis of GTBM, most likely caused by AN. We started treatment with nutritional support, and 6 months later, the hematological parameters returned to normal and BMI improved to 19.4 kg/m2. He was able to return to work and had no left heel pain. This case indicates that foot and ankle surgeons need to be aware of this rare pathology, although it might be difficult to diagnose without biopsy. To our knowledge, very few descriptions of GTBM in the calcaneus have been reported to date.