Anu  Gupta, Ganga  Singh, 
    A Prospective Observational Study Integrating Histopathological Examination and Microbiological Techniques for the Evaluation of Bone Marrow Granulomas in Suspected Infectious and Haematological Disorders,
    Research Journal of Medical Sciences,
    Volume 10,Issue 6,
    2016,
    Pages 735-740,
    ISSN 1815-9346,
    makrjms.2016.735.740,
    (https://makhillpublications.co/view-article.php?doi=makrjms.2016.735.740)
    Abstract: <p style="text-align:justify">Bone marrow granulomas are rare findings with diverse etiologies, including infections, haematological malignancies and immune‐mediated disorders. Diagnosing these lesions requires a multidisciplinary approach integrating clinical, histopathological and microbiological findings. To evaluate the clinicopathological and microbiological spectrum of bone marrow granulomas and to assess the diagnostic yield and concordance of histopathological and microbiological methods. This prospective observational study was conducted at Rohilkhand Medical College over two years, involving 50 patients with histologically confirmed bone marrow granulomas. Detailed clinical data were recorded and bone marrow aspirate and biopsy samples were evaluated using HandE staining, ZN, PAS/GMS, AFB/fungal culture and GeneXpert MTB/RIF. Final diagnoses were categorized based on integrated histopathological and microbiological correlation. Statistical analysis was conducted to assess associations between granuloma morphology and etiology. The majority of patients were middle‐aged males presenting with constitutional symptoms and cytopenias. Poorly formed necrotizing granulomas were most prevalent and significantly associated with tuberculosis (p=0.029). Ziehl‐Neelsen stain showed the highest diagnostic yield (30%), followed by GeneXpert and AFB culture. Tuberculosis was the most common etiology (40%), followed by haematological malignancies (26%) and fungal infections (18%). A combination of histopathology and microbiology established the diagnosis in 30% of cases. An integrated diagnostic approach combining histopathology and microbiology significantly enhances the etiological characterization of bone marrow granulomas. Granuloma morphology provides critical diagnostic clues, particularly in distinguishing infectious from neoplastic causes in high‐burden settings.</p>

    Keywords: Bone marrow granuloma; tuberculosis; histopathology; genexpert; haematological malignancy