Bone marrow biopsy 48 yrs female Pbf shows pancytopenia

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Dear Dr.Mohit, Presumptive bone marrow biopsy diagnosis of Chronic myeloproliferative disorder, Prefibrotic primary myelofibrosis was given based on histopathological findings alone and considering no secondary cause for the same. For defnitive diagnosis, However according to WHO 2008 Diagnostic criteria, all 3 major criteria plus at least two minor criteriamust be met. Major criterion- 1:Features of Prefibrotic primary myelofibrosis. 2:Not meeting WHO criteria for CML, PV, MDS or other myeloid neoplasm. 3:Demonstration of JAK2 V617F or other clonal marker (MPL W515K/L) or no evidence of reactive marrow fibrosis. Minor criterion- 1:Leukoerythroblastosis, 2:Increased serum LDH, 3:Anemia, 4:Palpable splenomegaly. Thank you dear Dr.Mohit. Best regards.
Sir, after you answer I feel like anything I say will be unnecessary! Thank you for your brilliant insight always :)
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Respected sir, thanks for the post. Bone marrow biopsy microscopy: Micropictographs show small to large megakaryocytes with aberrant nuclear/cytoplasmic ratio and hyperchromatic and irregularly folded nuclei and dense clustering with increased marrow cellularity, granulocytic proliferation and decreased erythropoiesis. Fibrosis is focally evident. Impression : PREFIBROTIC PRIMARY MYELOFIBROSIS. Thank you very much, Best regards.
Dear Dr.Mohit, can you summarize your findings of the bone marrow biopsy? thanks.
Thank you for your update sir.
Sections examined show hypercellular marrow spaces . All the three haemapoietic series of cells show marked dysplasia . Prominent dysplastic changes in megakaryocytic series of cells seen Abnormal localization of immature precursors ( ALIP) noted Prominent crushing artfefacts with streaming of nuclei seen there is evidence of fibrosis
Hypercellular Marrow with dysplastic changes in all the three lineages & focal fibrosis.P/O : MDS.
JAK2 mutational analysis and BCRABL mutaional analysis were negative
Pancytopenia No organomegaly and No lymphadenopathy
reactive marrow with active trilineage hematopoiesis
MDS cytogenetic panel was positive
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