Micromegakaryocytic transformation of myelofibrosis with myeloid metaplasia.
نویسندگان
چکیده
Correspondence: Rosangela Invernizzi, MD, Medicina Interna ed Oncologia Medica, Università di Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy. E-mail: [email protected] A63-year old man was referred to our Institute in 1995 because of asthenia, dyspnea and melena. In 1975 he had been found to have myelofibrosis with myeloid metaplasia; after a few months, because of a rapid enlargement of the spleen, he underwent splenectomy; then, because of progressive increases in his leukocyte and platelet counts, he was treated continuously with hydroxyurea. At admission he was pale and had massive hepatomegaly. Laboratory findings were as follows: Hb 6 g/dL, leukocyte count 153 109/L, platelets 197 109/L. A peripheral blood smear showed anisopoikilocytosis, many erythroblasts (16 per 100 leukocytes), neutrophils 35%, lymphocytes 10%, monocytes 5%, metamyelocytes 6 %, myelocytes 5%, other mononuclear cells 57%, and blasts 8% (Figure 1). There were evident morphological anomalies of the erythroid and granulocytic cells, i.e. polychromatic macrocytes, Howell-Jolly bodies, binuclear erythroblasts, with basophilic punctuation and cytoplasmic areas devoid of hemoglobin, tetraploid macropolycytes with twin or hypersegmented nuclei. Mononuclear cells were heterogeneous: some cells had lymphocyte-like features, with minimal cytoplasm, sometimes acidophilic, sometimes arranged in perinuclear spikes; other cells were larger, had eccentric nucleus, basophilic cytoplasm, cytoplasmic protrusions or budding. In these cells, often seen in groups, chromatin was condensed and hyperchromatic, with absent nucleoli. Figure 2. Peripheral blood smear (MGG 1,200). Two lymphocyte-like cells, a larger cell with basophilic cytoplasm and a morphologically undifferentiated blast.
منابع مشابه
Trisomy 13 in a case of myelofibrosis with myeloid metaplasia with early blastic transformation.
We describe a case of early myeloid blastic transformation in a 64-year-old man suffering from myelofibrosis with myeloid metaplasia. Both chronic and blastic phase cytogenetic analysis showed trisomy 13 to be the sole chromosome aberration. A potential role for this rare abnormality in determining such an unusually poor clinical outcome is discussed.
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MMM usually presents with fatigue, weight loss, splenomegaly with or without symptoms. Anemia and various alterations of the white blood cell and/or platelet count are frequently seen at diagnosis. Thrombocytopenia-related bleeding may occur. MMM must be distinguished from myelodysplasia with fibrosis, from acute megakayoblastic leukemia and acute myelofibrosis. As the disease progresses, incre...
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An unexpectedly high incidence of blast transformation after splenectomy has been reported in patients with myelofibrosis with myeloid metaplasia. However, whether this was associated with spleen removal after adjustment for risk factors was not determined. We conducted a multicenter historical cohort study of patients with myelofibrosis with myeloid metaplasia diagnosed from January 1970 throu...
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An unexpectedly high incidence of blast transformation after splenectomy has been reported in patients with myelofibrosis with myeloid metaplasia. However, whether this was associated with spleen removal after adjustment for risk factors was not determined. We conducted a multicenter historical cohort study of patients with myelofibrosis with myeloid metaplasia diagnosed from January 1970 throu...
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عنوان ژورنال:
- Haematologica
دوره 85 1 شماره
صفحات -
تاریخ انتشار 2000