Primary Myelofibrosis Differential Diagnoses

Updated: Aug 22, 2019
  • Author: Asheesh Lal, MBBS, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Diagnostic Considerations

Primary myelofibrosis must be differentiated from conditions in which marrow fibrosis is a secondary development. For example, in patients with carcinoma or lymphoma, bone marrow involvement may be associated with marrow fibrosis, which reverses after effective treatment of the underlying disease. Similarly, in histoplasmosis and tuberculosis, marrow fibrosis may result in granulomatous involvement of the bone marrow. 

Performing testing for bcr:abl gene rearrangements is important to exclude chronic myelogenous leukemia. JAK2V617F mutation can be detected in approximately 50–60% of patients with primary myelofibrosis. [19, 20, 21]

Differential Diagnoses