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Cellular aspirate smear showing predominantly mononuclear hypo-granulated cells (white arrow) which were positive for MPO staining, confirming their myeloid lineage. Occasional plasma cells are also noted (blue arrow).  

Hematological conditions associated with prolonged and excessive turnover of hematopoietic cells (especially, CML and MDS) are often characterized by presence of large lipid laden histiocytes with eccentric nuclei, as noted in this case (orange arrow). These cells are termed either as Sea blue histiocytes (cytoplasm with dense blue granules) or as Pseudo-Gaucher cells (cytoplasm with linear striations and fine granules).