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PERIPHERAL BLOOD COUNTS:
HB: 16.7 G/DL
HCT: 51.2 %
MCV: 92.6 FL
MCH: 30.2 PG
WBC: 13.3 x 10E9/L
ANC: 10.4 x 10E9/L
PLATELETS: 79 x 10E9/L
PERIPHERAL BLOOD FILM: Shows normochromic, normocytic red blood cells. There is erythrocytosis. There is leucocytosis with neutrophilia and reactive lymphocytes. Platelets are low on film. Few clumps and large platelets also seen.
BONE MARROW ASPIRATE: Cellular specimen showing active trilineage hematopoeisis. Erythropoiesis is normoblastic with dyserythropoietic features in the form of binucleation and nuclear to cytoplasmic asynchrony seen. Myelopoiesis is active and shows all stages of maturation and differentiation. M:E ratio is 2:1. Adequate megakaryocytes seen. Blast cells are less than 5%. Plasma cells are less than 3%. No non-hematopoietic clump or hemoparasite identified on the stained smear examined.
BONE TREPHINE TOUCH PREP: Reflective of bone marrow aspirate.
BONE TREPHINE (H&E) SECTION: Small, crushed specimen with aspiration artifacts and few cellular areas. Cellularity cannot be assessed. Cellular areas show erythroid and myeloid precursors. Megakaryocytes seen. No granuloma or infiltration/replacement identified in the sections examined.
RESULTS OF RETICULIN STAIN: Not suitable.
OPINION: Findings are suggestive of peripheral destruction /sequestration of platelets which may be immune mediated or secondary to drug, underlying systemic illness, infections or other causes. Clinical correlation is advised. Surveillance of peripheral blood counts is suggested. If thrombocytopenia persist or new cytopenias develops then bone marrow cytogenetics is advised.
DR. MUHAMMAD SALMAN ARIF, DR. ANILA RASHID,
M.B.B.S F.C.P.S (HAEMATOLOGY),F.R.C.PATH
RESIDENT HAEMATOLOGY CONSULTANT HAEMATOLOGIST
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