case_images: PMC5309395_01
case_images: Peripheral blood smear shows fragmented helmet shaped rbcs (red arrows) (2-3 per high power field).
case_images: CRIHEM2017-4619406.001.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.001.jpg
case_images: fig1
case_images: Peripheral smear showed marked schistocytosis (Figure 1) and dysplastic neutrophils (Figures 2(a) and 2(b)).
case_images: Peripheral blood smear (Wright Giemsa stain at 100x magnification) shows dysplastic neutrophils characterized by nuclear hypolobation (Pseudo-Pelger Huet) and decreased granules (a). Neutrophil with a nonlobated nucleus (b).
case_images: CRIHEM2017-4619406.002.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.002.jpg
case_images: fig2
case_images: Peripheral smear showed marked schistocytosis (Figure 1) and dysplastic neutrophils (Figures 2(a) and 2(b)).
case_images: Bone Marrow Core Biopsy: low power magnification, highly cellular bone marrow.
case_images: CRIHEM2017-4619406.003.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.003.jpg
case_images: fig3
case_images: There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
case_images: Bone Marrow Core Biopsy: picture (intermediate magnification, H&E) shows a hypercellular bone marrow with increased number of dysplastic megakaryocytes. Dysplastic features include nuclear hypolobation (a) and micromegakaryocytes (b).
case_images: CRIHEM2017-4619406.004.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.004.jpg
case_images: fig4
case_images: There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
case_images: Bone marrow aspirate smear: dysplastic megakaryocytes, 100x magnification multinucleated megakaryocyte.
case_images: CRIHEM2017-4619406.005.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.005.jpg
case_images: fig5
case_images: There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
case_images: Bone marrow aspirate smear: dysplastic megakaryocyte, 100x magnification megakaryocyte with nuclear hypolobation.
case_images: CRIHEM2017-4619406.006.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.006.jpg
case_images: fig6
case_images: There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
case_images: Bone marrow aspirate shows dyserythropoiesis including megaloblastic change (A) and nuclear budding (B).
case_images: CRIHEM2017-4619406.007.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.007.jpg
case_images: fig7
case_images: There was mild increase in reticulin fiber content making a myelophthisic process as the underlying cause of schistocytosis unlikely (Figures 3-7).
case_images: Bone marrow specimen showing 48,XX,+1,+14,t(14;22)(q32;q11.2),add(15)(q22),+16,add(16)(q12-13),add(17)(p11.2),-22,inc.
case_images: CRIHEM2017-4619406.008.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.008.jpg
case_images: fig8
case_images: Karyotype analysis in twenty metaphases was performed and revealed a complex karyotype in eight metaphases (Figures 8 and 9).
case_images: Bone marrow specimen showing 47,XX,+1,add(3)(q21),der(6)t(6;10)(q25;q11.2),+8,t(8;22)(q24.1;q11.2),-10,add(15)(q22),+16,add (16)(q12-13),add(17)(p11.2),add(19)(q13.1),-22.
case_images: CRIHEM2017-4619406.009.jpg
case_images: PMC5309395_01_CRIHEM2017-4619406.009.jpg
case_images: fig9
case_images: Karyotype analysis in twenty metaphases was performed and revealed a complex karyotype in eight metaphases (Figures 8 and 9).