A Case of ‘Wrinkled Tissue Paper’ Cells

Explore the case of a 73-year-old man with fatigue, Bone Pain, and pancytopenia. What is the diagnosis behind the ‘wrinkled tissue paper’ cells?

Gaucher's disease


A 73-year-old man presented with 1-month history of fatigue and diffuse bone pain. Laboratory studies showed pancytopenia and a whole-body MRI showed osteonecrosis of the right humerus and right femur. A bone marrow biopsy showed macrophages with a “wrinkled tissue paper” appearance in the cytoplasm. What is the diagnosis?

What is the most likely diagnosis?

Chronic lymphocytic leukemia
Gaucher’s disease
Mucopolysaccharidosis type 1
Niemann-Pick disease
Non-Hodgkin’s lymphoma

Bone Pain, Gaucher’s disease, Lysosomal storage disease, Pancytopenia, Splenomegaly

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