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. 2023 Feb 23;9:1050062. doi: 10.3389/fmed.2022.1050062

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Copyright © 2023 Panuccio, Tripepi, Postorino, Greve, Sabattini and Oliva.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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(A) First bone marrow biopsy: silver impregnation staining (x10) shows diffuse severe (grade 3) fibrosis. (B) First bone marrow biopsy: Hematoxylin Eosin (x10) shows depleted cellularity and frank osteosclerosis with bone thickening and remodeling. (C) First bone marrow biopsy: Hematoxylin Eosin (x10) shows residual decreased myelopoiesis. (D) Second bone marrow biopsy: silver impregnation staining (x10) shows variability of marrow fibrosis (severe 3 on the right side; moderate on the left side). (E) Second bone marrow biopsy: Hematoxylin Eosin (x10) shows mild improvement of the osteosclerosis. (F) Second bone marrow biopsy: Hematoxylin Eosin (x10) shows residual decreased myelopoiesis. (G) Third bone marrow biopsy: silver impregnation staining (x10) shows almost normalization of marrow fibrosis. (H) Third bone marrow biopsy: Hematoxylin Eosin (x10) shows clear-cut improvement of the osteosclerosis with normal appearing bone trabeculae. (I) Third bone marrow biopsy: Hematoxylin Eosin (x10) shows regular cellularity and myelopoiesis.