Hi, I was wondering if someone can explain what these results mean - I am not scheduled to see my doctor for another month and would like to understand before hand. This was for a suspected diagnosis of polycythemia vera. Thanks!
Source of Specimen: Bone marrow.
Elevated HGB, ? polycythemia.
1. Labeled with patient's name and hospital registration number.
Received in B5 fixative and transferred to formalin is a 1.2 cm brown, bony core; submitted for decalcification. (1ns) EL
1-2. Bone marrow, core biopsy, touch preparation, aspirate smear, and peripheral blood smear: Approximately 40% cellular bone marrow with tarilineage hematopoietic mturation, including abundant megakaryocytes. Please see COMMENT.
Our assessment of a bone marrow core biopsy cellularity is limited by marked retraction artifact, which renders assessment of cellularity difficult.
Megakaryocytes are abundant and include occasional clusters. Review of the bone marrow aspirate smear shows a rare megakaryocyte with atypical
(hypolobated) nucleus, but most of the megakaryocytes are cytologically unremarkable. A reticulin stain on the bone marrow core biopsy shows mild reticulin fibrosis that involves areas beyond blood vessels, but without formation of interlacing networks. An iron stain on the bone marrow aspirate smear shows trace storage iron. Sideroblastic iron is present, but ringed sideroblasts are not identified.
The morphologic features are not entirely specific for the diagnosis of a chronic myeloproliferative disorder. In particular, diagnosis of polycythemia vera requires clinical correlation and correlation with JAK2 mutation status.
In addition, we would recommend hemoglobin electrophoresis to examine the possibility of polycythemia due to a high affinity hemoglobin if clinically indicated.
A 500-cell differential count of the bone marrow aspirate smear reveals:
0.6% blasts, 1.2% progranulocytes, 43% other granulocytic precursors and neutrophils, 25.8% erythroid precursors, 20.4% lymphocytes, 3.6% eosinophils, 0.2% basophils, 4.8% monocytes, and 0.4% plasma cells.