Bone marrow nonneoplastic
Noninfectious systemic disorders
Alcohol abuse
Author: Nat Pernick, M.D.
Last author update: 1 December 2006
Last staff update: 5 January 2021
Copyright: 2002-2025, PathologyOutlines.com, Inc.
PubMed Search: Bone marrow alcohol abuse
Table of Contents
Definition / general | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Peripheral smear description | Peripheral smear images | Electron microscopy images | Differential diagnosis | Additional referencesCite this page: Pernick N. Alcohol abuse. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bonemarrowsubstanceabuse.html. Accessed March 31st, 2025.
Definition / general
- Has variable hematological effects (Alcohol Clin Exp Res 2004;28:619)
- May cause megaloblastic anemia due either to folate / B12 deficiency or without these deficiencies
- Cyanamide, used to prevent alcohol intake, may cause aplastic anemia (Eur J Clin Pharmacol 2005;61:467) or granulocytopenia (Intern Med 1997;36:640)
- Alcohol abuse may also cause sideroblastic anemia (Postgrad Med 1992;92:147), severe osteoporosis (Calcif Tissue Int 2005;76:79) or TTP (Eur J Intern Med 2004;15:262)
Case reports
- 32 year old man with severe pancytopenia (University of Pittsburg Case #428)
- 50 year old man with extensive alcohol and drug abuse, hypocellular marrow and increased blasts (Arch Pathol Lab Med 2005;129:e35)
- 50 year old woman with megaloblastic anemia due to alcohol and mild folate antagonists (Dtsch Med Wochenschr 2005;130:2139)
Microscopic (histologic) description
- May cause hypocellular marrow or reactive myeloblastosis with up to 34% blasts
- Vacuoles in proerythroblasts and other precursors
- Also ringed sideroblasts and iron granules in plasma cells
Microscopic (histologic) images
Images hosted on other servers:
Marked megaloblastic features
Markedly hypercellular
Bone marrow: intracytoplasmic vacuoless
Multiple coarses granules
Plasma cell: iron granules forming plaque
Hemosiderin granules in normoblast
Peripheral smear description
- Leukopenia with vacuoles, hypersegmentation of neutrophils, thrombocytopenia
- Iron granules in plasma cells and other cells
Peripheral smear images
Images hosted on other servers:
Peripheral blood erythrocytes
Vacuolation of peripheral blood cells
Electron microscopy images
Images hosted on other servers:
Marrow plasma cell has dense aggregate of iron
Iron laden organelle
in upper cell may
correspond to
microscopic plaque
Differential diagnosis
- Cytoplasmic vacuoles also due to copper deficiency, hematogones, lipid storage diseases, lipid granulomas, monocytes, Mott cells
Additional references
