<prompt> All are true regarding Myelofibrosis EXCEPTTear drop poikilocytesGiant abnormal plateletsLeucoerythroblastic blood pictureAbsence of splenic enlargement  <response>: D Absence of splenic enlargement Teardrop-shaped red blood cells indicative of membrane damage from passage through the spleen, a nucleated red blood cell, and immature myeloid cells indicative of extramedullary hematopoiesis are noted. This peripheral blood smear is related to any cause of extramedullary hematopoiesis. A blood smear will show the characteristic features of extramedullary hematopoiesis: teardrop-shaped red cells, nucleatec red cells, myelocytes, and promyelocytes; myeloblasts may also be present. Anemia, usually mild initially, is the rule, while the leukocyte and platelet counts are either normal or increased, but either can be depressed. Mild hepatomegaly may accompany the splenomegaly but is unusual in the absence of splenic enlargement; isolated lymph- adenopathy should suggest another diagnosis. Both serum lactate dehydrogenase and alkaline phosphatase levels can be elevated. Exuberant extramedullary hematopoiesis can cause ascites; portal, pulmonary, or intracranial hypertension; intestinal or ure eral obstruction; pericardial tamponade; spinal cord compression; or skin nodules. Splenic enlargement can be sufficiently rapid to cause splenic infarction with fever and pleuritic chest pain. Hyperuricemia and secondary gout may ensue. 