case_images: PMC8265497_01
case_images: Abdominal contrast-enhanced computed tomography (CT). Unilateral adrenal hemorrhage was
  detected in the right adrenal gland on day 11.
case_images: jslrt-61-109-g001.jpg
case_images: PMC8265497_01_jslrt-61-109-g001.jpg
case_images: f1
case_images: Contrast CT revealed slightly enlarged deep lymph nodes, bilateral pleural effusion, and right adrenal hemorrhage. (Fig. 1) All laboratory parameters deteriorated since admission, and the patient demonstrated leukocytosis (19,400/muL), anemia (Hb 10 g/dl), thrombocytopenia (105x109/L), and high levels of gamma-GTP (94 U/L), ALP (690 U/L), and CRP (21.26 mg/dl).
case_images: Bone marrow biopsy on day 16. (A) Gomori (x200) staining of the bone
  marrow biopsy specimen. Bone marrow fibrosis was classified as MF-1.
  (B) Wright (x200) staining of a bone marrow smear. Increasing numbers
  of megakaryocytes with slight dysplasia and plasma cells were observed. These are
  characteristic findings of TAFRO syndrome.
case_images: jslrt-61-109-g002.jpg
case_images: PMC8265497_01_jslrt-61-109-g002.jpg
case_images: f2
case_images: Pathological examination revealed bone marrow fibrosis classified as MF-1, and increased numbers of megakaryocytes with slight dysplasia and plasma cells. (Fig. 2) Based on these clinical findings, biochemical laboratory data, and histopathological results, the patient was diagnosed with TAFRO syndrome according to the 2019 updated diagnostic criteria.