PMC9479014_01
Bone marrow aspirate smear at diagnosis showing a hypercellular marrow with increased granulopoiesis. Neither dysplasia nor blast proliferation was observed. (Wright-Giemsa staining; original magnification, x 1000).
gr1.jpg
PMC9479014_01_gr1.jpg
fig0001
BM examination revealed a marked hypercellular marrow with increased granulopoiesis without dysplastic features, and the blasts were 0.5% (Fig. 1).
Contrast-enhanced computed tomography scans (a) on admission, (b) two weeks after hospitalization, and (c) three weeks after the initiation of ruxolitinib. (d) Clinical course of the present case.
gr2.jpg
PMC9479014_01_gr2.jpg
fig0002
CSF3R (T618I), ASXL1, TET2, and SRSF2 identified. Contrast-enhanced computed tomography (CT) revealed marked splenomegaly and multiple low-density areas in both kidneys (Fig. 2a). CRP levels; however, neutrophils levels surged and fever and CRP levels increased with withdrawal of hydroxyurea. CT revealed enlargement of the spleen and abscesses (Fig. 2b). One day after starting ruxolitinib, the patient's fever and fatigue resolved remarkably, and CRP levels normalized two weeks later (Fig. 2d). Abdominal CT showed shrinkage of splenomegaly and multiple bilateral renal abscesses (Fig. 2c).