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Therapy-related Myeloid Neoplasm- Bone marrow Aspirate 2

Therapy-related Myeloid Neoplasm- Bone marrow Aspirate 2
#00063057
Author: Manisha Goel; Girish Venkataraman
Category: Myeloid Neoplasms and acute leukemia (WHO 2016) > Acute Myeloid Leukemia > Therapy-related myeloid neoplasms
Published Date: 07/01/2020

Prominent megakaryocytic dysplasia is frequently observed in such cases. Note the multi-nucleated and non-lobated megakaryocytes with widely separated round nuclei (black arrow). One of the most reliable features of megakaryocytic dysplasia is the presence of a micromegakaryocyte (red arrow), which is approximately the size of a promyelocyte. Aberrant CD34 expression is often noted in dysplastic megakaryocytes and should be differentiated from blasts. 

Scattered dysplastic neutrophils in the smears are notable for cytoplasmic hypo-granularity, abnormal nuclear segmentation and increased chromatin clumping (purple arrow) when compared to normal neutrophils (green arrow).