Myelofibrosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2], Sujit Routray, M.D. [3]

Overview

Myelofibrosis must be differentiated from other diseases that cause diffuse bone sclerosis, such as sickle cell disease, hyperthyroidism, sclerosing bone dysplasia, osteoblastic metastases, and Paget's disease.^[1]^[2] Myelofibrosis must be differentiated from other diseases that cause splenomegaly, such as anemia, CML, polycythemia rubra vera, cirrhosis, infections, neoplastic, and lipid storage disorders.^[1]^[3]

Myelofibrosis must be differentiated from other diseases that cause diffuse bone sclerosis. They are presented in the table below.^[1]^[2]


Type of diseases	Diseases

Hematological causes	Sickle cell disease
Metabolic bone disorders	Hyperthyroidism Hypoparathyroidism Renal osteodystrophy
Congenital	Sclerosing bone dysplasia Osteopetrosis Pyknodysostosis
Malignancy	Lymphoma: infiltration Leukaemia: infiltration Osteoblastic metastases prostate cancer breast cancer
Other	Paget disease Fluorosis Mastocytosis Hepatitis C associated osteosclerosis (HCAO)

Myelofibrosis must be differentiated from other diseases that cause splenomegaly. They are presented in the table below.^[1]^[3]


Type of diseases	Diseases

Hematological causes	Anemia Sickle cell disease Thalassemia Hereditary spherocytosis Pyruvate kinase deficiency Thrombotic thrombocytopenic purpura (TTP) Neoplastic/proliferative/redistribution of hematopoesis Leukemia (especially CML) Polycythemia rubra vera (PRV) Waldenstorm macroglobulinemia Extramedullary hematopoiesis Osteopetrosis Idiopathic hypereosinophilic syndrome _{* = may cause massive splenomegaly}
Hemodynamic	Cirrhosis: portal hypertension Congestive splenomegaly (Banti's syndrome) Splenic vein obstruction Portal vein obstruction Right heart failure
Infection	Viral EBV (infectious mononucleosis) - (common) AIDS CMV Herpes simplex virus Rubella Bacterial Tuberculosis (miliary) Tularemia Subacute bacterial endocarditis Typhoid fever Brucellosis Syphilis Abscess Fungal Histoplasmosis (common) Candidiasis Parasitic disease Malaria* Schistosomiasis Hydatid disease Leishmaniasis (kala-azar) Rickettsial Typhus
Storage diseases/metabolic/infiltrative disorders	Gaucher disease Glycogen storage disease Mucopolysaccharidoses Niemann-Pick disease Hemochromatosis Amyloidosis Porphyria Sarcoidosis
Neoplastic	Lymphoma (common) Metastases (breast, lung, colon, ovary, melanoma) Hemangioma Lymphangioma Angiosarcoma
Trauma	Hematoma Pseudocyst
Connective tissue disorders	Systemic lupus erythematosus (SLE) Rheumatoid arthritis Felty's syndrome Juvenile rheumatoid arthritis (JRA) Still's disease

↑ ^1.0 ^1.1 ^1.2 ^1.3 Differential diagnosis of myelofibrosis. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2016. http://radiopaedia.org/articles/myelofibrosis. Accessed on March 10, 2016
↑ ^2.0 ^2.1 Diffuse bony sclerosis: differential diagnosis. Dr Craig Hacking and Dr Yuranga Weerakkody et al. Radiopaedia 2016. http://radiopaedia.org/articles/diffuse-bony-sclerosis-differential-diagnosis. Accessed on March 10, 2016
↑ ^3.0 ^3.1 Splenomegaly. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/Italic textarticles/splenomegaly. Accessed on March 11, 2016