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MCV= HCT( in L/L) / RBC ( in x 10 ^12/ L)   x 1000
MCV =   0.17 / 1.6 x 1000
= 106.5

RED CELL; (dyserythropoeitic features in bone marrow precursor)
-Red cells can have more than 1 population, normochromic/ovalomacrocytosis.
-Presence of sideroblast may present with variable population of HCMC population
-Presence of basophilic stippling, megaloblastoid nucleated red cells

WCC
-Instead of hypersegmented neutrophils; granulocytes display reduced or absent granulation and reduced segmentation ( pseudo pelger huet)

PLT
Usually morphology normal

~maryam jameelah

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The M:E ratio is the relative number of myeloid lineage cells to nucleated erythroid precursors in marrow. It indicates myeloid hyper/hypoplasia or erythroid hyper/hypoplasia. In this case increased marrow cellularity with increased M:E ratio indicates myeloid hyperplasia. M:E ratio normally 2:1-4:1.
S Ponnalagi

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Cellularity-
Hypercellular, normocellular, hypocellular, aplastic.
Cellularity is increased for age.
All cell line exhibit dyshematopoetic features
Increased in blast, promyelocyte, eosinophil.

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- hypercellular bone marrow

- erythroid : megaloblastoid changes of precursor

- myeloid : hypogranular with some binucleated

- megakaryocytes : monolobated with nuclear separation

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Differential count:complete spectrum of myeloid series (promyelocytes,myelocytes,meta&band form.
Eosinophilia
Blast less than 10% (cml-cp)
Bone marrow: hypercellular with myeloid dysplasia
Morphology of cells:neutrophils in mds is hypogranular and bilobed while in cml neutrophilia with normal morphology,erythroid in mds is megaloblastoid while in cml erythroid is normal size,megakaryocytes in mds is abnormal form but in cml normal form of mega
Cytogenetics:cml show presence of t9:22 philadelphia chr,but not present in mds.

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Cytopenia present in two cells lineage (bicytopenia) - Erythrocytic and megakaryocytic lineage.

Abnormalities:

Presence of immature cells of myeloid series (blasts,promyelocyte,myelocyte,metamyelocyte) and increase neutrophilic band.
Lymphopenia.
Eosinophilia.

~ Afif ~

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hyposegmentation of neutrophils (pseudo pelger hue
hypogranulation of neutrophils.
presence of immature cells of myeloid series i.e. myelocytes, metamyelocytes, promyelocytes, blasts.
eosinophilia

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1. Serum B12
2. RBC Folate
3. Serum homocysteine
4. Serum methylmalonic acid

By Roslina

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What does the M:E ration indicate?
What is the normal ratio?

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What chemistry test wud be helpful to rule out megaloblastic anemia?

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Identify at least 2 features of the bone marrow that are compatible with a diagnosis of MDS

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How would u classify the marrow cellularity and which of the hematopoietic cell line exhibit dyshematopoiesis in the bone marrow?

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What features of the differential resemble CML? What helps to distinguish this from CML?

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BMAT was performed

75% cellularity

myeloid hyperplasia with 9% blast

26% promyelocytes

18% myelocytes

6%metamyelocytes

4% band

37% eosi

M:E ratio 12:1

The myelocytes were hypogranular and some with binucleated

Erythroid precursor showed megaloblastoid changes

Mega adequate but showed abnormal form with nuclear separartion and monolobated.

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Calculate the MCV.What peripheral blood findings are helpful to rule out megaloblastic anemia?

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What evidence of dyspoiesis is seen in the leukocyte morphology

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In what cell lines is cytopenia present? and what abnormalities are present in the differential?

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GROUP 1  (Q1- Q
Mr K , a 66 yo male coplaint of fatigue, malaise, anorexia and hemoptysis of recent onset. FBC was ordered, showed anemia and left shifted in IG. Other hematopoietic cells showed dysplastic features.

FBC RESULT

Rbc  1.6

Hb   5.8

Hct  0.17 L/L

WBC  10.5

Plt  39

Retic 0.8%

Differential Count

Segmented neut 44%

7% band

6% lymp

28% eosi

1% meta

1% mylocytes

9% promyelocytes

4% blasts

FBP

marked hyposegmentation and hypogranulation of neutrophils

RBC anisopoikilocytosis, tear drop, ovalocytes, schistocytes