Hematogones in immune thrombocytopenic purpura: diagnostic implication

Hematogones (HGs) are benign immature B cells in bone marrow with a variety of benign and malignant conditions, including idiopathic thrombocytopenic purpura, leukemia, lymphoma, red blood cell aplasia, iron deficiency anemia, amegakaryocytosis, regenerative bone marrow following viral injury...

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Main Authors: Arzu Akyay, Mesude Falay, Seda Oztürkmen, Zafer Biçakci, Betül Tavil, Gülsüm Ozet, Lale Olcay
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2011-04-01
Series:The Turkish Journal of Pediatrics
Online Access:https://turkjpediatr.org/article/view/1757
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author Arzu Akyay
Mesude Falay
Seda Oztürkmen
Zafer Biçakci
Betül Tavil
Gülsüm Ozet
Lale Olcay
author_facet Arzu Akyay
Mesude Falay
Seda Oztürkmen
Zafer Biçakci
Betül Tavil
Gülsüm Ozet
Lale Olcay
author_sort Arzu Akyay
collection DOAJ
description Hematogones (HGs) are benign immature B cells in bone marrow with a variety of benign and malignant conditions, including idiopathic thrombocytopenic purpura, leukemia, lymphoma, red blood cell aplasia, iron deficiency anemia, amegakaryocytosis, regenerative bone marrow following viral injury, chemotherapy or bone marrow transplantation, copper deficiency, autoimmune cytopenias, neuroblastoma, and acquired immunodeficiency syndrome (AIDS). HGs may cause diagnostic problems because of their morphologic and immunophenotypic similarities to neoplastic lymphoblasts. Herein, two patients with thrombocytopenia and three lineage dysplasias in the bone marrow suggesting myelodysplastic syndrome (MDS) with excess blasts are presented. Light microscopic evaluation of marrow from both patients revealed periodic acid-Schiff (PAS)-negative blasts However, flow cytometric analysis revealed excessive HGs in both patients, implying that the cells that were considered as blasts were actually large HGs. Thus, the patients were diagnosed as immune thrombocytopenic purpura due to the isolated thrombocytopenia, large platelets on blood and bone marrow smears and increased megakaryocytes in the bone marrow. These cases emphasize the importance of distinction of hematogone-rich conditions from leukemia and MDS for accurate diagnosis and treatment, and the reliability of multiparameter flow cytometry for the differential diagnosis.
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issn 0041-4301
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language English
publishDate 2011-04-01
publisher Hacettepe University Institute of Child Health
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series The Turkish Journal of Pediatrics
spelling doaj-art-5306ae2fb24a456cadfdfdcb085bbd2a2025-08-20T03:00:54ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212011-04-01532Hematogones in immune thrombocytopenic purpura: diagnostic implicationArzu Akyay0Mesude FalaySeda OztürkmenZafer BiçakciBetül TavilGülsüm OzetLale OlcayUnit of Pediatric Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Turkey. Hematogones (HGs) are benign immature B cells in bone marrow with a variety of benign and malignant conditions, including idiopathic thrombocytopenic purpura, leukemia, lymphoma, red blood cell aplasia, iron deficiency anemia, amegakaryocytosis, regenerative bone marrow following viral injury, chemotherapy or bone marrow transplantation, copper deficiency, autoimmune cytopenias, neuroblastoma, and acquired immunodeficiency syndrome (AIDS). HGs may cause diagnostic problems because of their morphologic and immunophenotypic similarities to neoplastic lymphoblasts. Herein, two patients with thrombocytopenia and three lineage dysplasias in the bone marrow suggesting myelodysplastic syndrome (MDS) with excess blasts are presented. Light microscopic evaluation of marrow from both patients revealed periodic acid-Schiff (PAS)-negative blasts However, flow cytometric analysis revealed excessive HGs in both patients, implying that the cells that were considered as blasts were actually large HGs. Thus, the patients were diagnosed as immune thrombocytopenic purpura due to the isolated thrombocytopenia, large platelets on blood and bone marrow smears and increased megakaryocytes in the bone marrow. These cases emphasize the importance of distinction of hematogone-rich conditions from leukemia and MDS for accurate diagnosis and treatment, and the reliability of multiparameter flow cytometry for the differential diagnosis. https://turkjpediatr.org/article/view/1757
spellingShingle Arzu Akyay
Mesude Falay
Seda Oztürkmen
Zafer Biçakci
Betül Tavil
Gülsüm Ozet
Lale Olcay
Hematogones in immune thrombocytopenic purpura: diagnostic implication
The Turkish Journal of Pediatrics
title Hematogones in immune thrombocytopenic purpura: diagnostic implication
title_full Hematogones in immune thrombocytopenic purpura: diagnostic implication
title_fullStr Hematogones in immune thrombocytopenic purpura: diagnostic implication
title_full_unstemmed Hematogones in immune thrombocytopenic purpura: diagnostic implication
title_short Hematogones in immune thrombocytopenic purpura: diagnostic implication
title_sort hematogones in immune thrombocytopenic purpura diagnostic implication
url https://turkjpediatr.org/article/view/1757
work_keys_str_mv AT arzuakyay hematogonesinimmunethrombocytopenicpurpuradiagnosticimplication
AT mesudefalay hematogonesinimmunethrombocytopenicpurpuradiagnosticimplication
AT sedaozturkmen hematogonesinimmunethrombocytopenicpurpuradiagnosticimplication
AT zaferbicakci hematogonesinimmunethrombocytopenicpurpuradiagnosticimplication
AT betultavil hematogonesinimmunethrombocytopenicpurpuradiagnosticimplication
AT gulsumozet hematogonesinimmunethrombocytopenicpurpuradiagnosticimplication
AT laleolcay hematogonesinimmunethrombocytopenicpurpuradiagnosticimplication