Megakaryocyte changes in thrombocytopenia in bone marrow aspiration
Journal Title: Medpulse International Journal of Pathology - Year 2018, Vol 6, Issue 3
Abstract
Background: Megakaryocyte (MK) is one of the vital hematopoietic cell encountered in the bone marrow aspirate smears. MK has been studied extensively in the past and is known to show dysplastic changes in thrombocytopenia associated with Myelodysplastic Syndrome (MDS). Only a few studies have been conducted to know the MK changes in other non-MDS cases. This project was undertaken to study MK changes in thrombocytopenia in non-MDS hematological conditions. Objective: To study the megakaryocytic alterations in thrombocytopenia in bone marrow aspiration smears in non-MDS hematological conditions. Results: Total 110 cases of patients presenting with non-MDS hematological conditions with thrombocytopenia were included in the study. MK number was normal in cases of megaloblastic anemia (88.6%), multiple myeloma, Gaucher`s disease and HIV infection. MK was increased in cases of ITP (100%) and megaloblastic anemia (11.4%) where else it was decreased in acute leukemia (100%), aplastic anemia, lymphoma and metastatic condition. MK observed in megaloblastic anemia cases were with nuclear separation (100%) followed by bare nuclei (54.3%) and emperipolesis (45.7%). In all the 23 cases of acute leukemia, MK was of normal morphology. In ITP cases, MK showed emperipolesis (100%) followed by nuclear separation (83.3%), bare nuclei (50%), hypolobated forms (50%) and cytoplasmic vacuolization (16.6%). Conclusion: MK morphological changes are not uncommon in thrombocytopenia in non-MDS hematological conditions and they should be considered and given due importance as are erythroid / Myeloid cell changes given during the diagnostic evaluation.
Authors and Affiliations
Ashwini V Ratnakar, Suresh Hanagavadi
Keywords
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