Bone marrow is usually diagnostic

• Hypercellular BM with normal cell maturation, typical of marrow stimulation causes.

• Infiltration with neoplastic cells of a 2° malignancy may be identified as abnormal clumps with characteristic morphology—immunohistochem-istry may identify the primary source e.g. PSA for prostate.

• Increase in reticulin fibres running in parallel bundles identifies fibrotic infiltrative cause—usually myelofibrosis, but may occur with other haematological malignancy.

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