PMC4672073_01
Bone marrow aspirate - blast, promyelocyte along with mature myeloid cells (A, Jenner Giemsa stain, x1000). Bone marrow biopsy showing diffuse replacement by immature myeloid cells with no fibrosis. (B, Hematoxylin & Eosin stain, x400). Bone marrow aspirate - strong MPO positivity (C, myeloperoxidase stain, x1000). Karyogram showing 45X, -X, t(11;17)(q23;q21) (D, karyotype).
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Since she had high TLC, bone marrow examination and cytogenetics were carried out which revealed abnormal promyelocytes and 45X, -X, t(11;17)(q23;q21) respectively (Fig. 1). The bone marrow biopsy showed near total replacement by immature myeloid forms without marrow fibrosis (Fig. 1).
Bone marrow biopsy showing diffuse fibrosis with collagenisation along with entrapped immature myeloid cells (A - Hematoxylin & Eosin stain, x100, B - Hematoxylin & Eosin stain, x400, C - reticulin stain, x100, and D - Masson trichrome stain, x400).
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The bone marrow biopsy tissue revealed dense diffuse marrow fibrosis with extensive collagen deposition suggestive of grade III marrow fibrosis confirmed on Masson trichrome stain, with entrapped immature myeloid forms of similar morphology observed in the diagnostic marrow (Fig. 2).