Mucoid bone marrow without carcinoma deposits.

Case reports Case 1 A male born in 1903. He had a past history of duodenal ulceration. In 1959, after a coronary occlusion, he complained of difficulty in swallowing food. A barium swallow showed narrowing and irregularity of the distal end of the oesophagus reaching just above the diaphragm. At oesophagoscopy a 3-cm length of yellow slough and hyperaemia was observed, and biopsy was considered to be highly suspicious of cancer. However, no firm diagnosis was made, and he was not followed up. When seen in 1961, interest was confined to his cardiac state only. It would appear that he volunteered no gastro-intestinal symptoms. In 1966 he complained of epigastric pain. A barium meal was not satisfactory technically, but it was thought that his duodenum did show much scarring. His haemoglobin concentration was 17-7 g/100 ml. His final admission occurred in 1967. He noted more difficulty in swallowing. His haemoglobin concentration had fallen to 5 2 g/100 ml, and he had a 10% reticulocytosis. His serum iron was 60 ,ug/ 100 ml and faecal occult blood was present. Bone marrow was aspirated from the posterior iliac crest, and revealed much mucinous material through the marrow clumps, which stained metachromatically with the Romanowsky stains (Fig. 1). No neoplastic cells were identified. A barium meal showed rigidity of the lower twothirds of the oesophagus, and some irregularity of the lesser curve of the stomach, which was not narrowed.