Cytological Clues of Bone Marrow Findings in Kala-Azar

A case-control study was done on 77 cases in divided groups in order to test the sensitivity and specificity of new diagnostic morphologic criteria for visceral leishmaniasis. We found cytological findings other rather than the presence of intracytoplasmic Leishman Donovan bodies, i.e., the following interrelated items: 1) hypolymphopoiesis; 2) dyserythropoiesis; 3) blebbing of the granulocytic series and exfoliation of the blebs as "granular stippling;" and 4) various-sized damaged of the activated macrophages to apoptotic ones and cytoplasmic blebbing of the parasitophorous vacuoles and exfoliation of them as empty "basophilic bare cells." These two latter findings were based on our own observations over the past few years. Statistical analysis showed that these new criteria have more efficacy in diagnosis than previous ones; the differences were statistically significant. Findings obtained from this study could increase the values of diagnostic histopathological methods for detecting visceral leishmaniasis.