PMC6586112_01
Peripheral smear H&E stain. Pseudo Pelger-Huet neutrophil: a finding seen in MDS, can also be seen in B12 deficiency. This finding is characterized by a bilobed nucleus, and markedly reduced granulation.
ZJCH_A_1622382_F0001_PB.jpg
PMC6586112_01_ZJCH_A_1622382_F0001_PB.jpg
F0001
Analysis of the peripheral smear revealed slight anisocytosis, polychromasia, dyserythropoiesis, dysplastic neutrophils, absence of schistocytes, and left shifted myeloid cell lines with few blasts (Figures 1, 2).
Peripheral smear H&E stain. (a) Dyserythropoiesis Giemsa stain 1000x. Nuclear budding is evident in image.
ZJCH_A_1622382_F0002_PB.jpg
PMC6586112_01_ZJCH_A_1622382_F0002_PB.jpg
F0002
Analysis of the peripheral smear revealed slight anisocytosis, polychromasia, dyserythropoiesis, dysplastic neutrophils, absence of schistocytes, and left shifted myeloid cell lines with few blasts (Figures 1, 2).
Bone marrow aspirate one day after admission. (a) Erythroid and megakaryocyte hyperplasia: The bone marrow is hypercellular with ineffective erythropoiesis. (b) Megakaryocyte dysplasia. The megakaryocytes are abnormal with multiple small lobes seemingly disconnected from one another.
ZJCH_A_1622382_F0003_PB.jpg
PMC6586112_01_ZJCH_A_1622382_F0003_PB.jpg
F0003
On day two of the hospitalization a bone marrow biopsy was performed (Figure 3).