Figure 1
Figure 1: (A) The bone marrow aspirate demonstrates hypercellularity for age, trilineage dysplasia with 52% megakaryoblasts. The megakaryoblasts are described as agranular, medium-to-large cells with round nucleus, scanty basophilic cytoplasm with cytoplasmic blebs and pseudopods. Erythropoiesis and granulopoiesis are suppressed. (B) H & E stain of trephine biopsy (x 40 magnification) shows infiltration of marrow by large clusters of megakaryoblasts. (C-E) A panel of immunohistochemical staining, Dako, Denmark (x 40 magnifications) shows positivity for CD34 and CD61 and negativity for MPO. (F) Reticulin stain shows Grade 2 marrow fibrosis.