case_images: PMC9894644_01
case_images: Peripheral smear and bone marrow evaluation. A. Wright-stained peripheral blood smear showing marked thrombocytopenia. The neutrophils show mostly normal morphology.. B. Wright-stained bone marrow aspirate smear with clusters of atypical large cells showing a high N/C ratio and fine chromatin. Mild to moderate nuclear polymorphism is present.. C. Hematoxylin-eosin-stained bone marrow core biopsy shows clusters of neoplastic cell infiltrate. The residual trilineage hematopoiesis is seen here with an adequate number of megakaryocytes.. The neoplastic cells seen on the bone marrow biopsy stained positive for INSM1 (D), SSTR2A (E), and synaptophysin (F) by immunohistochemistry.
case_images: cureus-0015-00000033297-i01.jpg
case_images: PMC9894644_01_cureus-0015-00000033297-i01.jpg
case_images: FIG1
case_images: The peripheral blood smear is depicted in Figure 1A. The aspirate smear is seen in Figure 1B, and the core biopsy is in Figure 1C. Representative immunohistochemical (IHC) stains performed on the core biopsy are shown in Figure 1D-1F.