PMC4177064_01
Showing increased number of mast cells demonstrated by H&E stain in (a), immunohistochemical staining for tryptase in (b) and D117 in (c), respectively (x20).
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PMC4177064_01_12878_2013_28_Fig1_HTML.jpg
Fig1
Increased numbers of MCs in paratrabecular location were highlighted by immunohistochemical staining for CD117 and tryptase (Figure 1a, b and c).
Showing aggregates of mast cells containing mixed black and orange color round cytoplasmic granules and a giant segmented basophil in (a) (wright's stain x 100), brown color round granular cytoplasmic staining demonstrated by tryptase immunohistochemical staining on PB smear representing mast cells in (b) (x100).
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PMC4177064_01_12878_2013_28_Fig2_HTML.jpg
Fig2
MCs on PB smear as they were seen in the BM smear. MCs have round nuclei, one or more nucleoli in immature forms and mixed black and orange color round cytoplasmic granules (Figure 2a). Tryptase immunohistochemical staining of PB smear showed brown color round granular cytoplasmic staining in the aggregates of cells (Figure 2b).
Demonstrating basophils at various stages of maturation,giant binuclear basophilic metamyelocyte, aggregates of mast cells with mixed black and orange color round cytoplasmic granules and Pelger-Huet anomalies in (a) (Wright's stain, x100). Showing diffuse granular staining by peroxidase stain in peroxidase positive basophils and absence of staining in aggregates of cells that representing myeloperoxidase negative mast cells in the BM in (b) (Peroxidase stain, x100).
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PMC4177064_01_12878_2013_28_Fig3_HTML.jpg
Fig3
Striking dysplasia manifested as giant segmented basophils, giant basophilic bands, giant binuclear basophilic metamyelocytes, frequent Pelger-Huet anomaly (Figure 3a) and binuclear eosinophilic metamyelocytes were seen. PB and BM smears demonstrated diffuse granular metachromatic staining in the great majority of cells including MCs and basophils when transformation to MCL was detected. Peroxidase stain of BM smear showed diffuse granular staining in <60% of non-erythroid nucleated BM cells and peroxidase negative aggregates of cells (Figure 3b).