Page 41 - Haematologica Atlas of Hematologic Cytology

CHAPTER 4 - Viral infections
ABC
DEF
Figure 4 4 Human immunodeficiency virus (HI ) infection A 48-year-old man man had complained of fatigue for ap- proximately a a a a a a a a a a year and and and presented recurrent fever and and and weight loss At physical examination modest pallor and and and cervical lymhadenopathies were found A blood count showed mild normocytic anemia (hemoglobin 10 9 g/dL) reticulocytopenia slight thrombocytopenia (platelets 93x109/L) and leukopenia (white blood cell count 3 3 5x109/L) with with lymphopenia ( ) Peripheral blood smear reveals slight dysplastic changes of neutrophils with with anisocytosis and and and abnormalities of nuclear segmentation (right) ( ( and and and ) ) Bone marrow cellularity is slightly reduced and and and the hemopoietic lineages are represented at at at at all stages of of maturation with moderate hypoplasia of of the erythroid se- ries The proportion of lymphocytes and and plasma cells is increased (D and and ) At higher magnification no particular morphological alterations of the erythroid and granulocytic cells are noted A trephine biopsy showed increased number of of macrophages with cellular debris and reticulin fibrosis Serological testing allowed a a a a a a a a diagnosis of of HIV
infection infection In HIV
HIV
infection infection morphological changes in in in in in in in in bone bone marrow are non-specific While in in in in in in in in the early phase cellularity is is normal and and infiltration by lymphocytes and and plasma cells may be present in in advanced disease bone marrow is is is hypocellular with reticulin fibrosis and aspiration is is is difficult moreover dysplastic features of the he-
matopoietic cells such as as megaloblastosis (F) and giant metamyelocytes may be observed 28