Concluded Case

HLH

2 years female with pancytopenia Bone marrow aspiration slides for opinion

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Pancytopenia in pbs. Clinical data? 2yrs child. Hypercellular marrow. Normoblastic hyrrplasia. Granulocytic precursors diminished. Megakaryocytes.. appear just adequate. Many bizzare and large hisiocytes with evidence of erythrophagocytosis/emperipolesis. Fine pinkish amorphous material in background. Histiocytic proliferation.. leading to Myelophthisic state. Dd. Haemophagocytic syndrome Histiocytosis(LCH.. vs. Non. LCH) Sug. Clinical correlation S. Ferritin. Trephine bx Imagaing. Skull x ray Ihc.

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Pancytopenia in pbs. Clinical data? 2yrs child. Hypercellular marrow. Normoblastic hyrrplasia. Granulocytic precursors diminished. Megakaryocytes.. appear just adequate. Many bizzare and large hisiocytes with evidence of erythrophagocytosis/emperipolesis. Fine pinkish amorphous material in background. Histiocytic proliferation.. leading to Myelophthisic state. Dd. Haemophagocytic syndrome Histiocytosis(LCH.. vs. Non. LCH) Sug. Clinical correlation S. Ferritin. Trephine bx Imagaing. Skull x ray Ihc.

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Haemophagocytic syndrome/ LCH

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It’s Haemophagocytic syndrome /LCH

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Cellular smears show increased atypical cells ? Blasts. Myeloid & erythroid series of cells are reduced. Megakaryocyte is seen. Emperpolesis noted. Impression Acute leukemia . Adv FCM for confirmation.

Hemophagocytic lymphohistiocytosis

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