case_images: PMC4739215_01
case_images: Morphologic findings in liver and bone marrow biopsy. (a) H&E stain of liver, (b) H&E stain of bone marrow biopsy, and (c) reticulin stain of bone marrow biopsy.
case_images: CRIHEM2016-9515404.001.jpg
case_images: PMC4739215_01_CRIHEM2016-9515404.001.jpg
case_images: fig1
case_images: The liver parenchyma was unremarkable with no evidence of rejection or increased fibrosis (Figure 1).
case_images: Reticulin stain of the bone marrow biopsy showing increased fibrosis.
case_images: CRIHEM2016-9515404.002.jpg
case_images: PMC4739215_01_CRIHEM2016-9515404.002.jpg
case_images: fig2
case_images: Additional work-up included a bone marrow biopsy that revealed a hypercellular marrow (60 percent), polymorphous trilineage hematopoiesis, moderate to severe reticulin fibrosis (grade 2/3), and 1% blasts (Figure 2).
case_images: H&E stain of the bone marrow biopsy showing atypical megakaryocytes.
case_images: CRIHEM2016-9515404.003.jpg
case_images: PMC4739215_01_CRIHEM2016-9515404.003.jpg
case_images: fig3
case_images: The number of megakaryocytes was not markedly abnormal but showed clustering on a subsequent bone marrow biopsy (Figure 3).