case_images: PMC5966691_01
case_images: Bone marrow biopsy (a) at diagnosis of acute myeloid leukemia (AML) demonstrating infiltration by myeloblasts; (b) after one course of AML therapy showing atypical megakaryocyte morphology and focal clustering; (c) at diagnosis of myeloproliferative neoplasm (MPN) with myeloid hypercellularity and increased megakaryocytes; and (d) at diagnosis of MPN demonstrating increased reticulin deposition.
case_images: CRIHEM2018-8713020.001.jpg
case_images: PMC5966691_01_CRIHEM2018-8713020.001.jpg
case_images: fig1
case_images: The bone marrow aspirate was hypercellular with the vast majority of cells either myeloblasts or monoblasts, all consistent with a diagnosis of acute myeloid leukemia (AML) of myelomonocytic type (Figure 1(a)). The bone marrow trephine biopsy at this time showed no evidence of blasts but remained hypercellular with some abnormal megakaryocyte forms showing focal clustering (Figure 1(b)). Megakaryocytes were increased in number with some immature forms being seen and an increase in mature myeloid cells to erythroid cells (Figure 1(c)). Staining for reticulin demonstrated increased deposition (Figure 1(d)), resulting in a diagnosis of MPN unclassified.