Bone Marrow Fibrosis (BMF): A New Proposal for Grading System

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Bone Marrow Fibrosis (BMF): A New Proposal for Grading System

Birgees Mazhar Kazi*, Faiza Kazi**, Masood Anwar***
* National Institute of Health, Islamabad.
** Foundation Medical College, Rawalpindi.
*** Armed Forces Institute of Pathology, Rawalpindi.

Semi-quantitative evaluation of Bone Marrow Fibrosis (BMF) in trephine biopsies is important in laboratory workup of many
haematological lesions. Various grading systems for the study of patterns and extent of Fibrous Tissue Content (FTC) have
been used previously. In this paper, a new grading system for FTC has been proposed and studied in trephine biopsies of 160
cases of various haematological lesions. BMF was observed in 59% of cases. The grading system applied in this study was
found quite comprehensive, and it was easy to segregate BMF into various grades with the help of this system. Grade 1
fibrosis was the commonest (35.1%), followed by Grade 2 (28.7%), Grade 3 (24.5%) and Grade 4 (11.5%), respectively. Van
Giesen’s trichrome stain was found useful for demonstration of collagen in Grade 4 fibrosis.
Key words: Bone Marrow Fibrosis; Grading System; Fibrous Tissue Content.


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