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Histological examination of the bone marrow. (A) The bone marrow aspiration shows an excess of platelets (white arrow) and a lymphoplasmacytoid lymphocyte (black arrow), which has a shoe shaped cell with pale blue cytoplasm and an irregular nucleus (giemsa staining; x1000). (B) A lymphoplasmacytoid lymphocyte (black arrow) with pale blue cytoplasm and an eccentric nucleus (giemsa staining; x1000). (C) The bone marrow trephine shows increased numbers of lymphocytes and an excess of mature megakaryocytes with hyperlobulated nuclei (black arrow; hematoxylin and eosin staining; x400).
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The BM aspirate morphology showed an excess of platelets and lymphoplasmacytoid lymphocytes (Figure 1A and B). The trephine reported cellularity of 55%, with increased numbers of lymphocytes and mature megakaryocytes with hyperlobated nuclei (Figure 1C).
Flow cytometry immunophenotyping result of the bone marrow. The flow cytometry confirmed the presence of monoclonal B lymphocytes, which were positive for CD19, CD20 and cell membrane light chain kappa, but negative for CD5, CD10 and CD23. Blue dots denote lymphocytes.
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Flow cytometric immunophenotyping of his BM aspirate confirmed monoclonal B lymphocytes, which were positive for CD19, CD20 and cell membrane kappa light chain, but negative for CD5, CD10 and CD23 (Figure 2).