PMC4402729_01
a. Hypercellular bone marrow with increased megakaryocytes and a prominent non-paratrabecular lymphoid aggregate (H&E, x100 eryhtroid cells). b. Reticulin stain highlights diffuse and dense increase in reticulin with extensive intersections (Reticulin, X100). c. Trichrome stain demonstrates coarse bundles of collagen (Trichrome, X100).
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F1
Repeat bone marrow biopsy showed 100% cellularity (Fig. 1A). Reticulin stain highlighted diffuse and dense increase in reticulin with extensive intersections in all areas, and trichrome stain demonstrated coarse bundles of collagen (Fig. 1B and 1C) corresponding to bone marrow fibrosis grade MF-3.
a. Anti-CD3 antibody highlights numerous T-cells within lymphoid aggregates (CD3, IHC, X100). b. Anti-CD20 antibody demonstrates substantially smaller amount of B-cells within lymphoid aggregates (CD20, IHC, X100). c. Anti-CD61 antibody highlights numerous megakaryocytes including small monolobated forms (CD61, IHC, X100). d. Anti-CD34 antibody highlights small vessels and dilated sinuses with intrasinusoidal hematopoiesis and rare single immature hematopoietic cells (CD34, IHC X100).
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F2
Immunohistochemical stains demonstrated a mixture of B- and T-lymphocytes within the lymphoid aggregates, with a predominance of CD8+ T-lymphocytes (Figs. 2A and 2B). Anti-CD61 antibody highlighted numerous clustering megakaryocytes (Fig. 2C). Anti-CD34 antibody highlighted small vessels and dilated sinuses with intrasinusoidal hematopoiesis and rare single immature hematopoietic cells (Fig. 2D).