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Hematology

Blue Bone Marrow in Severe Megaloblastic Anemia

A clinical case of pancytopenia: sternal puncture revealed blue bone marrow syndrome and erythroid hyperplasia with a predominance of megaloblasts.

Nana Novikova Nana Novikova 1 min
Bone marrow smear: megaloblasts, binucleated erythroid precursor
Bone marrow smear: megaloblasts, binucleated erythroid precursor
Bone marrow smear: predominance of basophilic megaloblast forms and a mitotic figure
Bone marrow smear: predominance of basophilic megaloblast forms and a mitotic figure
Bone marrow smear: characteristic lacy chromatin structure of megaloblasts
Bone marrow smear: characteristic lacy chromatin structure of megaloblasts
Bone marrow smear: erythroid hyperplasia, blue bone marrow phenomenon
Bone marrow smear: erythroid hyperplasia, blue bone marrow phenomenon
Bone marrow smear: cluster of basophilic megaloblasts of varying maturity
Bone marrow smear: cluster of basophilic megaloblasts of varying maturity
Bone marrow smear: asynchrony of nuclear and cytoplasmic maturation in erythroblasts
Bone marrow smear: asynchrony of nuclear and cytoplasmic maturation in erythroblasts
Bone marrow smear: megaloblastic erythropoiesis with abundant basophilic forms
Bone marrow smear: megaloblastic erythropoiesis with abundant basophilic forms
Bone marrow smear: megaloblasts at different stages of differentiation and mitosis
Bone marrow smear: megaloblasts at different stages of differentiation and mitosis
Bone marrow smear: pronounced basophilia of the cytoplasm of young erythroblasts
Bone marrow smear: pronounced basophilia of the cytoplasm of young erythroblasts
Bone marrow smear: mature megakaryocyte with a multi-lobed nucleus
Bone marrow smear: mature megakaryocyte with a multi-lobed nucleus

“BLUE” BONE MARROW. Sternal puncture was performed for diagnostic purposes due to severe anemia. In the complete blood count:

  • RBC 1.9×10^12/L
  • HGB 72 g/L
  • WBC 2.3×10^9/L
  • PLT 88×10^9/L.

In the bone marrow aspirate, an increase in the number of erythroblasts to 75.2% (N 14.5-26.5) is noted. Megaloblasts, with a predominance of basophilic forms. Photo 10 - megakaryocyte.

🙏 The publication was kindly provided by KDL doctor Nana Novikova, CHUZ “KB” RZHD-Meditsina, Smolensk.

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