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Persistence and morphological progression of myelodysplastic syndrome with multilineage dysplasia and fibrosis meeting criteria of refractory anemia with multilineage dysplasia and excess of blasts type 2
Bone Marrow, Iliac Crest
Haematoxylin & Eosin (H&E)
42 years
42-year old female patient with myelodysplastic syndrome.
Representative bone marrow core biopsy with massive increase in megakaryocytes arranged in groups and clusters, embedded in a dense network composed of collagenous and sparse reticular fibers, defining a myelofibrosis grade 3. Distinct osteosclerosis. Massive increase in iron storage.
Immunohistochemical stain for CD34 shows increased density of small vessels and augmentation of blasts up to 18% which form ALIP (abnormal localized immature myeloid precursor). E-Cadherin stain shows few erythropoietic islets. Mast cell tryptase stain shows scattered mast cells without formation of clusters.
Andrea Bodmer, University of Basel
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