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Oncohematology

Blast Morphology in Bone Marrow in Pancytopenia

Clinical case of pancytopenia in an 82-year-old female patient: evaluation of blast morphology with cytoplasmic vacuolization in bone marrow aspirate.

Anna Belen Anna Belen 1 min
Bone marrow smear: cluster of blasts with distinct vacuoles in the cytoplasm
Bone marrow smear: cluster of blasts with distinct vacuoles in the cytoplasm
Bone marrow smear: blast cells with numerous small vacuoles
Bone marrow smear: blast cells with numerous small vacuoles
Bone marrow smear: blasts with basophilic cytoplasm and optically empty vacuoles
Bone marrow smear: blasts with basophilic cytoplasm and optically empty vacuoles
Bone marrow smear: atypical blasts with delicate chromatin and vacuolization
Bone marrow smear: atypical blasts with delicate chromatin and vacuolization
Bone marrow smear: field of view with a predominance of blast cells of different sizes
Bone marrow smear: field of view with a predominance of blast cells of different sizes
Bone marrow smear: group of vacuolated blasts in the aspirate
Bone marrow smear: group of vacuolated blasts in the aspirate
Bone marrow smear: blasts with pronounced granularity and cytoplasmic vacuoles
Bone marrow smear: blasts with pronounced granularity and cytoplasmic vacuoles
Bone marrow smear: blast cells and single mononuclears against a background of erythrocytes
Bone marrow smear: blast cells and single mononuclears against a background of erythrocytes
Bone marrow smear: large blast with a chain of small vacuoles along the edge of the cytoplasm
Bone marrow smear: large blast with a chain of small vacuoles along the edge of the cytoplasm

Patient, 82 years old, with pancytopenia in blood. Clinical case from 🇮🇱 Israel. 🩸 Complete blood count: WBC 1.19; Hb 84; PLT 74. Differential leukocyte count: 8% blasts, 17% neutrophils, 63% lymphocytes, 10% monocytes, 2% basophils. 🦴 Bone marrow aspirate is presented in the photos below.

❓ Can we determine the lineage of blasts by morphology? What unusual features can we note?

🔬The case was kindly shared by the Head of the Morphology/IFT Department of the HaEmek Medical Center Laboratory, Afula, 🇮🇱Israel - Anna Belen.

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