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Myeloid neoplasia with eosinophilia and rearrangement of PDGFR-Alpha gene.
Bone Marrow, Iliac Crest
Haematoxylin & Eosin (H&E)
74 years
74-year old male patient with myeloproliferative disease.
Representative bone marrow trephine biopsy showing age-correlated hypercellularity (100%; packed marrow). Megakaryopoiesis is increased and cytologically atypical with rather small cells. Myelopoiesis is hyperplastic, and shows a left shift and impaired maturation, but is focally maturing. Erythropoiesis is irregularly spread and broadly hypoplastic. Diffuse myelofibrosis grade 1-2. Marked eosinophilia in the background.
CD61 stains the increased and cytologically atypical megakaryopoiesis. CD 34 stains small vessels which are increased in density, but no blasts are detected. CD14 and CD11c stain isolated mature cells of monopoiesis. CD123 stain does not reveal any islets of plasmocytoid dendritic cells.
Due to massive eosinophilia, bone marrow morphology and peripheral blood count suspicion for a disease belonging to the category of myeloid neoplasia with eosinophilia and recurrent genetic abnormality of PDGFR or FGFR was reported. Genetic analysis proved a rearrangement of PDGFR-Alpha, which allowed to finally classify the case.
Andrea Bodmer, University of Basel
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