case_images: PMC2637293_01
case_images: Photomicrograph of bone marrow trephine biopsy (case 1) shows hypocellular marrow spaces with 70% of fat cells. There are reduced numbers of hematopoietic cells with increased numbers of blasts (a, b). One of the focuses shows an area of bone marrow necrosis punctuated by hyperchromatic blasts and histiocytes (c, d). Hematoxylin and eosin stain, a x40; b x400; c x40; d x400.
case_images: 1752-1947-3-27-1.jpg
case_images: PMC2637293_01_1752-1947-3-27-1.jpg
case_images: F1
case_images: Erythroid series of cells were relatively preserved, however, myeloid and megakaryocytic lineages were markedly suppressed (Figure 1a, b). In addition, a focus of necrosis involving less than 20% of the biopsy area, along with scattered blasts was also seen at one edge of the biopsy (Figure 1c, d).
case_images: PMC2637293_02
case_images: Bone marrow aspirate smear (case 2) shows hypocellular marrow spaces with less than 50% cellularity and more than 30% blasts. Wright Giemsa stain, a x40; b x600.
case_images: 1752-1947-3-27-2.jpg
case_images: PMC2637293_02_1752-1947-3-27-2.jpg
case_images: F2
case_images: There was an increased amount of fat, and marrow cells were replaced by blasts (88% of marrow cells) (Figure 2a, b).