PMC5309395_01
Peripheral blood smear shows fragmented helmet shaped rbcs (red arrows) (2-3 per high power field).
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fig1
Peripheral smear showed marked schistocytosis (Figure 1) and dysplastic neutrophils (Figures 2(a) and 2(b)).
Peripheral blood smear (Wright Giemsa stain at 100x magnification) shows dysplastic neutrophils characterized by nuclear hypolobation (Pseudo-Pelger Huet) and decreased granules (a). Neutrophil with a nonlobated nucleus (b).
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fig2
Peripheral smear showed marked schistocytosis (Figure 1) and dysplastic neutrophils (Figures 2(a) and 2(b)).
Bone Marrow Core Biopsy: low power magnification, highly cellular bone marrow.
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fig3
There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
Bone Marrow Core Biopsy: picture (intermediate magnification, H&E) shows a hypercellular bone marrow with increased number of dysplastic megakaryocytes. Dysplastic features include nuclear hypolobation (a) and micromegakaryocytes (b).
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fig4
There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
Bone marrow aspirate smear: dysplastic megakaryocytes, 100x magnification multinucleated megakaryocyte.
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fig5
There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
Bone marrow aspirate smear: dysplastic megakaryocyte, 100x magnification megakaryocyte with nuclear hypolobation.
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fig6
There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
Bone marrow aspirate shows dyserythropoiesis including megaloblastic change (A) and nuclear budding (B).
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fig7
There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
Bone marrow specimen showing 48,XX,+1,+14,t(14;22)(q32;q11.2),add(15)(q22),+16,add(16)(q12-13),add(17)(p11.2),-22,inc.
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fig8
Karyotype analysis in twenty metaphases was performed and revealed a complex karyotype in eight metaphases (Figures 8 and 9).
Bone marrow specimen showing 47,XX,+1,add(3)(q21),der(6)t(6;10)(q25;q11.2),+8,t(8;22)(q24.1;q11.2),-10,add(15)(q22),+16,add (16)(q12-13),add(17)(p11.2),add(19)(q13.1),-22.
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fig9
Karyotype analysis in twenty metaphases was performed and revealed a complex karyotype in eight metaphases (Figures 8 and 9).