PMC7388081_01
BM cell morphology with hematoxylin-eosin staining at high magnification
(100X) of the patient at the time of diagnosis, which showed a
hypercellular marrow and high granular level that indicates high degree
of dysgranulopoiesis.. BM, bone marrow.
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Morphological examination of bone marrow (BM) aspirate showed a thrombocytosis and hypercellular marrow with high degree of dysgranulopoiesis, including 0.5% myeloblasts, 3.5% promyelocytes, 9% myelocytes, 3% metamyelocytes, 10% eosinophils, 4.5% lymphocyte, 2% nucleated red blood cells, and 9.5% monocytes (Figure 1).
Blood smear at high magnification (100X) at the time of diagnosis:
myelocytes and metamyelocytes could be found in peripheral blood with
granulocytosis.
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Manual differential count of peripheral blood also revealed a granulocytosis (Figure 2).
Immunohistochemical analysis of BM core biopsy at high magnification
(200X) demonstrating CD71+ (panel 1) and CD61+
(panel 2). BM core biopsy with MPO+ (panel 3). Meshinprotein
staining at high magnification (100X) demonstrating grade 1 BM fibrosis
(panel 4).. BM, bone marrow; MPO, myeloperoxidase.
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Meshinprotein staining was consistent with grade 1 BM fibrosis (Figure 3).