PMC5660754_01
Peripheral blood smear (Wright-Giemsa stained, 100x): peripheral smear showing anemia, with numerous elliptocytes and thrombocytopenia.
CRIHEM2017-3625946.001.jpg
PMC5660754_01_CRIHEM2017-3625946.001.jpg
fig1
Review of the peripheral smear showed marked elliptocytosis (Figure 1).
(a) Bone marrow aspirate (Wright-Giemsa stain, 100x). High magnification of the bone marrow aspirate shows a marrow with erythroid hyperplasia, megaloblastic maturation, and a dysplastic erythroid cell (arrow). (b) Bone marrow aspirate (Wright-Giemsa stained, 100x). High magnification of the bone marrow aspirate shows a dysplastic megakaryocyte with separate lobes. (c) Bone marrow aspirate (Iron stain, 100x). The iron stained aspirate shows multiple ring sideroblasts (>15%) (arrows).
CRIHEM2017-3625946.002.jpg
PMC5660754_01_CRIHEM2017-3625946.002.jpg
fig2
A bone marrow biopsy was performed which showed a hypercellular marrow with erythroid hyperplasia, dyserythropoiesis and dysmegakaryopoiesis, and adequate stainable iron with >15% ring sideroblasts and 3% blasts (Figure 2).