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case_images: Figure 1 shows flowcytometric analysis on peripheral blood of CD34 antigen on blast population (a) shows histogram of CD34+blasts (B) shows scatter diagram of CD34 vs CD 45. Blasts are CD34 + and CD45 + (c) shows scatter diagram of CD 45 vs cMPO. Blasts are negative for cytoplasmic myeloperoxidase (d) Figure shows 4.1% blasts gated using CD45 vs SSC gating strategy
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case_images: Antibodies against CD41, CD61, glycophorin A could not be used as they were not available at that time. 4.1% blasts were gated which were CD45 positive (moderate) and had low side scatter. 46% of gated blasts were positive for CD34 (Figure 1).
case_images: Figure 2 shows panmyeloid proliferation with dyspoietic unilobated megakaryocytes(arrow). (Hematoxylin and eosin x 40x).
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case_images: Bone marrow aspirate was unsuccessful but bone marrow biopsy (Figure 2) revealed hypercellular bone marrow with panmyeloid proliferation.
case_images: a & b (inset) shows increased WHO grade III fibrosis on reticulin stain(Gomori silver impregnation technique(a-10x)(b-40x).
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case_images: Reticulin stain revealed a characteristic WHO grade III myelofibrosis (Figure 3).
case_images: Figure 4 shows CD 34 positive blasts with a working internal control (arrow-endothelium) (10x) (DAKO automated immunostainer-streptavidin biotin - peroxidase based technique).
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case_images: Blasts were positive for CD34 (Figure 4) and negative for CD61, anti MPO and glycophorin A.