PMC6815613_01
Baseline chest X-ray.
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The chest X-ray was normal (Figure 1).
(a, b) Peripheral blood smear revealing schistocytes and eosinophil (May-Gruunwald stain). (c) Partially degranulated eosinophils and schistocytes (May-Grunwald stain). (d, e) Bone marrow aspirate (May-Grunwald stain, 400x magnification). (f) Bone marrow trephine biopsy (hematoxylin-eosin stain, 200x magnification).
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Peripheral blood film showed schistocytosis (4%) with eosinophilia in partly degranulated forms (Figures 2(a)-2)(c). Erythroid and myeloid precursors showed progressive and orderly maturation (Figures 2(d) and 2(e)). Myeloid precursors were adequate with prominently increased eosinophilic lineage cells (Figure 2(f)).
Fluorescence in situ hybridization (FISH) analysis for FIP1L1/CHIC/PDGFRA (using Vysis/Abbott FISH probes) revealed FIP1L1/PDGFRA (4q12) rearrangement in 20.5% of the scored nuclei. ISCN: nuc ish (FIP1L1x2, CHICx1, PDGFRAx2) (FIP1L1 con PDGFRA) (41/200).
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FISH study done on the bone marrow aspirate for FIP1L1/PDGFRA (4q12) rearrangement detected abnormal signals in 26% of the 200 scored nuclei (Figure 3).
Clinical course, platelet count, hemoglobin, LDH, and eosinophil count of the patient. LDH, lactate dehydrogenase; PLEX, plasma exchange.
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