Bone marrow - nonneoplastic
Infectious / inflammatory
Parvovirus (erythrovirus) B19

Author: Nat Pernick, M.D. (see Authors page)

Revised: 13 July 2017, last major update December 2006

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PubMed Search: Bone marrow [title] parvovirus B19

Cite this page: Parvovirus (erythrovirus) B19. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonemarrowparvovirusB19.html. Accessed November 21st, 2017.
Definition / general
  • Associated with HIV but serology may be negative because patients cannot produce IgG antibodies (Hum Pathol 2000;31:161)
  • Affects bone marrow erythroid precursors, causing transient aplastic crisis in patients with hemolytic anemia or chronic anemia
  • Affects placenta and other tissues in fetuses, causing fetal hydrops or death
  • Also causes erythema infectiosum (Fifth disease), arthropathy (note: B19 DNA is common in rheumatic patients but clinical significance is unclear, J Clin Virol 2005;33:71)
  • B19 DNA found in bone marrow of 2% of healthy individuals (J Clin Microbiol 2002;40:933)
  • Erythrovirus V9 causes similar pathology (J Clin Microbiol 1999;37:2483)
  • Chronic parvovirus infection: associated with immunodeficiency, erythroid hyperplasia, numerous inclusions, particularly in basophilic and polychromatic erythroblasts
Case reports
Microscopic (histologic) description
  • Marked erythroblast hypoplasia, immature giant erythroblasts
  • Occasional erythroblasts may have intranuclear inclusions with surrounding rim of residual chromatin
  • Rarely hemophagocytosis (Jpn J Infect Dis 2005;58:149)
Microscopic (histologic) images

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50 year old man: rare pronormoblast forms

Large and megaloblastic pronormoblast forms


HIV+ patient

Giant pronormoblast

Giant cell with eosinophilic nuclear inclusion

Pronormoblasts are B19+

B19+


B19+ cells in bone marrow biopsy

Positive stains
  • Hemoglobin A, B19
Electron microscopy images

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Displacement of chromatin to margin by virus particles

Native parvovirus B19

Differential diagnosis
Additional references