Peripheral Blood Morphology in Secondary Myelodysplastic Syndrome

Clinical case of MDS after chemotherapy with stromal fibrosis: severe poikilocytosis, hyposegmented neutrophils, normoblastosis, and blasts in a blood smear.

Tanya Stepanova 1 min January 3, 2026

Blood smear: anisocytosis, poikilocytosis of erythrocytes and a single polychromatophil

Blood smear: poikilocytosis with dacryocytes and oval forms of erythrocytes

Blood smear: vacuolated neutrophil with signs of nuclear hyposegmentation

Blood smear: dysplastic neutrophil with pelgeroid nuclear hyposegmentation

Blood smear: neutrophil with hyposegmented nucleus and cytoplasmic vacuolization

Blood smear: granulocyte with nuclear hyposegmentation against a background of erythrocyte poikilocytosis

Blood smear: oxyphilic normoblast with signs of dyserythropoiesis

Blood smear: normoblast with asynchronous maturation of nucleus and cytoplasm

Blood smear: polychromatophilic normoblast with signs of dyserythropoiesis

Blood smear: blast cell with delicate chromatin and high N:C ratio

Myelodysplastic syndrome, developed after chemotherapy. With stromal fibrosis grade 2-3. Severe anemia. Mild thrombocytopenia without hemorrhagic syndrome. Patient’s peripheral blood.

➡49 normoblasts were found per 100 leukocytes. Their morphology varies. Binucleated forms with asynchronous nuclear maturation are present (7,8,9)

🔹Anisocytosis of erythrocytes (1,2) 🔹Poikilocytosis of erythrocytes (dacryocytes, ovalocytes) (1,2) 🔹Polychromatophilic erythrocytes (1,2) 🔹Blast (10) 🔹Vacuolated neutrophils with nuclear hyposegmentation (3,4,5,6)

🙏 The publication was kindly provided by laboratory physician Tanya Stepanova, Volgograd