Thiele et al reported a grading scheme for bone marrow fibrosis in patients with myelofibrosis. This is based on a consensus conference and review of the literature. The authors are from Europe and the United States.
Specimen: bone marrow core biopsy
Special stains required: reticulin (for reticulin fibers) and trichrome (for collagen)
Parameters:
(1) reticulin fibers (assessed in cellular areas with hematopoiesis)
(2) reticulin fiber intersections (cross-overs)
(3) other findings
Reticulin Fibers
Intersections
Other Findings
Grade
scattered, linear
none
none
MF-0
loose network
many, especially in perivascular areas
none
MF-1
diffuse and dense
extensive
focal bundles of collagen and/or focal osteosclerosis
MF-2
diffuse and dense
extensive
coarse bundles of collagen, with or without signficant osteosclerosis
MF-3
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