Synopsis

 increased silver (reticulin) staining
 marked fibrosis with pockets of cellularity that have fibroblasts and atypical megakaryoblasts
 bone marrow hyperplasia with predominance of megakaryocytic and erythroid precursors is observed (slight increase in reticulin staining)

• more typical of (adult) agnogenic myeloid metaplasia with myelofibrosis

Etiology

 primary myelofibrosis

• agnogenic myeloid metaplasia with myelofibrosis (AMMM)
• acute myelofibrosis
• acute myelofibrosis of childhood (C-AMF)
• myelofibrosis associated with myelodysplastic syndrome

 secondary myelofibrosis

• acute leukemia
  • acute megakaryoblastic leukemia (AMKL) (M7 acute leukemia)
  • acute myeloid leukemia
  • acute lymphoblastic leukemia

• chronic myelogenous leukemia
• non-Hodgkin lymphoma
• essential thrombocythemia
• Hodgkin disease (reported cases in adults only)
• Langerhans cell histiocytosis
• Sickle cell disease
• Fanconi anemia
• Infectious causes
  • Tuberculosis
  • visceral leishmaniasis
  • histoplasmosis

• Vitamin D deficiency
• renal osteodystrophy
• systemic lupus erythematosus
• Gray platelet syndrome
• osteopetrosis
• hyperparathyroidism
• hypoparathyroidism
• pernicious anemia
• Gaucher disease
• exposure to radiation
• thorium dioxide exposition
• benzene exposition