Concomitant deposition of aluminum and iron in bone marrow trabeculae.

A 53-year-old man was admitted with cervical and inguinal lymphadenopathy. Computed tomography scans showed mediastinal and paraaortic lymphadenopathy and multiple nodular lesions in the liver. An inguinal lymph node biopsy revealed anaplastic Ki-1-positive lymphoma. Laboratory examination showed blood urea nitrogen 66 mg/dl, creatinine 3.6 mg/dl, uric acid 9.9 mg/dl, serum iron 130 μg/dl, total iron binding capacity 140 μg/dl, and ferritin 3,735 ng/ml. He was given one course of combination chemotherapy (cyclophospamide, vincristine, adriamycin, prednisolone). This was followed by progression of renal failure and hemodialysis was performed for 5 days with recovery of the renal function. One month later, however, meningeal involvement and nodal regrowth occurred and the patient died of cerebral hemorrhage shortly after the second course of chemotherapy. Postmortem examination showed infiltration of lymphoma cells in the lymph nodes, heart, lungs, liver, and pancreas. Vertebral bone marrow was hypoplastic with trabecular narrowing and scarcity (Fig. 1). Deposits