PMC9906038_01
a BM aspirate, Wright-Giemsa stain. Cytoplasmic vacuoles in erythroid and myeloid precursors. BM biopsy revealed hypercellular marrow (80-90%) with dysplastic features in the erythroid lineage. These changes included cytoplasmic vacuoles in erythroid and myeloid precursors. These findings pointed toward a diagnosis of MDS. b BM aspirate, Wright-Giemsa stain: Rare erythroid cells with nuclear budding BM biopsy additionally revealed rare erythroid cells also showing nuclear budding, which contributed to the possible diagnosis of MDS.
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PMC9906038_01_cro-2023-0016-0001-528899_f1.jpg
F1
There were cytoplasmic vacuoles in erythroid and myeloid precursors with rare erythroid cells also showing nuclear budding, as seen in Figure 1a and b, respectively.
BM aspirate, iron stain. Ring sideroblasts. BM aspirate also revealed ring sideroblasts, which are not consistent with the diagnosis of MDS. This finding prompted the team to draw a copper level, as this finding can be seen in copper deficiency.
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F2
Additionally, ring sideroblasts were increased by 14%, as seen in Figure 2.