PMC5541803_01
Bone marrow aspiration showed increased number of megakaryocytes, particularly those with hypolobulated nuclei. There was not any other abnormality in the bone marrow smear.
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Bone marrow aspirated biopsy (Figure 1) confirmed a peripheral thrombocytopenia.
Kinetics of a platelet count during the follow-up of ITP-ET patient. *ITP relapse.
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Platelet counts remained stable till 2007 when they started to increase slowly and reached 704 G/L in January 2013 (Figure 2), while hemoglobin level was 15.4 g/dL and leukocytes were 5.85 G/L. The last control was performed in February 2017, and patient was in good condition with platelet count 113 G/L without any medication (Figure 2).
Trephine biopsy revealed normocellular bone marrow without fibrosis with normal differentiation of granulocytic and erythroid lineage. A marked increase in megakaryocytic density was present. Megakaryocytes presented with moderate pleomorphism, most cells showing nuclear hyposegmentation with normal nuclear to cytoplasmic ratio (a) and a few myeloproliferative hypersegmented and atypical forms. Moreover megakaryocytic lineage displayed focal aggregation (b).
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ARMS method). According to WHO 2008 diagnostic criteria, bone marrow biopsy was done, and it was compatible with ET (Figure 3).