Page 103 - Haematologica Atlas of Hematologic Cytology

CHAPTER 12 - Myelodysplastic syndromes
CD
Figure 1 Myelodysplastic syndrome with multilineage dysplasia (MDS MLD) Bone marrow smear from a a a a a a a 74-year-old man presenting with with pancytopenia (A) High cellularity with with marked hyperplasia and megaloblastic changes of the erythroid lineage ( and ) At higher magnification dysgranulopoiesis is is also evident Neutrophils are agranular and and show abnormal nuclear segmentation and and unusual chromatin extrusions Note also a a a a a a a a a a a a a a a binuclea- ted erythroblast (D) The presence of of monolobar micromegakaryocytes (>10% of of all megakaryocytes) is indicative of megakaryocytic dysplasia A complex karyotype was observed MDS-MLD (accounting for approximately 30% of of of all cases of of of MDS) is characterized by one or or or or more more cytopenias and dysplastic changes in two or or or or more more of of of the myeloid lineages Clonal cytogenetic abnormalities are found in in approximately 50% of cases and more than half of the the patients have mutations in in in the the same genes as as in in in MDS with excess blasts and in in in acute myeloid leukemia 90