PMC4739215_01
Morphologic findings in liver and bone marrow biopsy. (a) H&E stain of liver, (b) H&E stain of bone marrow biopsy, and (c) reticulin stain of bone marrow biopsy.
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The liver parenchyma was unremarkable with no evidence of rejection or increased fibrosis (Figure 1).
Reticulin stain of the bone marrow biopsy showing increased fibrosis.
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Additional work-up included a bone marrow biopsy that revealed a hypercellular marrow (60 percent), polymorphous trilineage hematopoiesis, moderate to severe reticulin fibrosis (grade 2/3), and 1% blasts (Figure 2).
H&E stain of the bone marrow biopsy showing atypical megakaryocytes.
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The number of megakaryocytes was not markedly abnormal but showed clustering on a subsequent bone marrow biopsy (Figure 3).