PMC3855249_01
A photomicrograph of the hypocellular bone marrow showing limited hematopoiesis and numerous fat cells.
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A bone marrow analysis showed hypocellular marrow with a percentage below 5%, without specific markers for other causes of pancytopenia, such as leukemia, lymphoma, or myelodysplastic syndrome (Fig. 1).
A chest radiograph taken just after the placement of a cuffed and tunneled central venous catheter. The patient was placed in the supine position, and the patency of the right internal jugular vein (RIJV) was confirmed by duplex Doppler ultrasound. After the successful puncture of the RIJV, a catheter was placed, with the tip of the catheter kept at the level of the atrium.
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After confirming the patency of the right internal jugular vein (RIJV) by duplex Doppler ultrasound, a cuffed and tunneled central venous catheter (The Split-Cath  14 French, MedComp, Harleysville, PA, USA) was placed there under local anesthesia in a standard radiological fashion, with the tip of the catheter kept at the level of the atrium as described previously (Fig. 2).