Dacryocytes are a common morphologic feature of autoimmune and microangiopathic haemolytic anaemia

2015 ◽  
Vol 53 (7) ◽  
Author(s):  
Christoph Robier ◽  
Daniela Klescher ◽  
Gerhard Reicht ◽  
Omid Amouzadeh-Ghadikolai ◽  
Franz Quehenberger ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Haemolytic Anaemia ◽  
High Power ◽  
Clinical Routine ◽  
Morphologic Feature ◽  
Microangiopathic Haemolytic Anaemia ◽  
Routine Diagnosis ◽  
Blood Smears ◽  
Secondary Myelofibrosis ◽  
Peripheral Blood Smears

AbstractDacryocytes are teardrop-shaped erythrocytes which are most frequently observed in peripheral blood smears of patients with primary or secondary myelofibrosis as well as malignant infiltrative disorders of the bone marrow. Dacryocytes have rarely been described in blood smears of patients with autoimmune (AIHA) and microangiopathic haemolytic anaemia (MAHA). The clear prevalence of dacryocytes in AIHA and MAHA is unknown.We compared the dacryocyte counts in blood smears stained according to the May-Grünwald-Giemsa technique between 20 subjects with AIHA and MAHA with those from 21 controls. The dacryocytes, defined as erythrocytes tapered to a point at one end, were counted as cells per 20 high power fields (HPF) at 630-fold magnification.In AIHA, MAHA and controls, dacryocytes were found in 89%, 91% and 19% of the slides, respectively. The rate of dacryocyte positivity and the dacryocyte counts between haemolytic anaemias and controls differed statistically highly significant (p<0.0001).The results of this study indicate that dacryocytes are commonly apparent in blood smears of patients with AIHA and MAHA. Knowledge of this frequent feature may be beneficial in clinical routine diagnosis.

Paris-Trousseau syndrome : clinical, hematological, molecular data of ten new cases

2003 ◽  
Vol 90 (11) ◽  
pp. 893-897 ◽  
Author(s):  
Remi Favier ◽  
Katayoun Jondeau ◽  
Patrice Boutard ◽  
Paul Grossfeld ◽  
Philippe Reinert ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Blood Platelets ◽  
Clinical History ◽  
Molecular Data ◽  
Biological Data ◽  
Pathogenic Role ◽  
Trousseau Syndrome ◽  
Blood Smears ◽  
Peripheral Blood Smears

SummaryParis-Trousseau syndrome (PTS) is an inherited disorder char-acterized by mild hemorragic tendency associated with 11q chromosome deletion. Here we report ten new patients (5 boys,5 girls) with complete clinical history, biological data, ultra-structural and molecular investigations. Thrombocytopenia is chronic in all the patients except two boys in whom it disappeared during the two first years of life. On Romanovsky stained peripheral blood smears, abnormal platelets with giant granules were detected in all the children and confirmed by electron microscopy (EM). On bone marrow smears, dysmega-karyopoiesis with many micromegakaryocytes was constantly observed. Abnormal alpha-granules were virtually absent from bone marrow and cultured megakaryocytes, while EM detected numerous images of granule fusion within blood platelets. Molecular analyses evidenced that the fli-1 gene is deleted in all the patients except one confirming the crucial role of the transcription factor FLI-1 in megakaryopoiesis. In summary, this study documents ten new cases of PTS with characteristic alpha-granule abnormalities, and shows the putative pathogenic role of fli-1 gene in the pathophysiology of this syndrome.

scholarly journals Bone marrow histopathology in POEMS syndrome: a distinctive combination of plasma cell, lymphoid, and myeloid findings in 87 patients

Blood ◽  
2011 ◽  
Vol 117 (24) ◽  
pp. 6438-6444 ◽  
Author(s):  
Linda N. Dao ◽  
Curtis A. Hanson ◽  
Angela Dispenzieri ◽  
William G. Morice ◽  
Paul J. Kurtin ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Poems Syndrome ◽  
Skin Changes ◽  
Bone Marrow Histopathology ◽  
Blood Smears ◽  
Peripheral Blood Smears ◽  
Lymphoid Aggregates

Abstract POEMS is an uncommon syndromic disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes. There are few descriptions of the bone marrow pathology of POEMS; therefore, peripheral blood smears and bone marrow aspirates and biopsies from 87 patients (143 total, 67 pretreatment, 76 posttreatment cases) with POEMS were studied. Plasma cell clonality was analyzed by flow cytometry, immunohistochemistry, and/or in situ hybridization. Monotypic plasma cells were detected in 44 pretreatment cases (66%); the majority of plasma cells expressed λ light chain (91%). The monotypic plasma cells typically were present in a background of increased polytypic plasma cells. Lymphoid aggregates were found in 33 (49%) pretreatment cases and in most cases were rimmed by plasma cells (97%). Megakaryocyte hyperplasia (36 cases) and clusters (62 cases) were frequent; however, none of the 43 cases tested had the JAK2V617F mutation. In summary, we have identified a novel constellation of features that should strongly suggest POEMS syndrome as part of the differential diagnosis. The constellation of λ-restricted monoclonal gammopathy, plasma cell rimming around lymphoid aggregates, and megakaryocytic hyperplasia in a bone marrow is highly suggestive of this diagnosis, especially in the context of a peripheral neuropathy.

scholarly journals Leucocyte alkaline phosphatase in the Mongolian gerbil and other species: a comparative view

1988 ◽  
Vol 22 (3) ◽  
pp. 202-205 ◽  
Author(s):  
J. H. Tamburlin ◽  
C. A. Glomski
Keyword(s):  
Bone Marrow ◽  
Alkaline Phosphatase ◽  
Enzymatic Activity ◽  
Mongolian Gerbil ◽  
Semiquantitative Assessment ◽  
Closely Related Species ◽  
Blood Smears ◽  
Wide Range ◽  
Peripheral Blood Smears ◽  
Leucocyte Alkaline Phosphatase

Cytochemical analyses performed on peripheral blood smears of the Mongolian gerbil reveal the presence of variable amounts of leucocyte alkaline phosphatase (LAP) activity in the neutrophil of this species. Levels of activity in individual cells ranged from 1 to 4+. Cells completely devoid of activity were rarely encountered. Immature neutrophils residing in the bone marrow also displayed moderate amounts of enzymatic activity. The results of a semiquantitative assessment of overall LAP activity in this rodent, expressed as a mean LAP score, were compared with similar analyses carried out on a diverse sample of vertebrates. Intermediate levels of activity were recorded for the gerbil ( x̄=241). This score was comparable to that obtained for the rat x̄=199) and significantly higher than that seen in man x̄=79). A wide range of LAP scores were noted for closely related species, as well as phylogenetically distant species.

scholarly journals UNCOMMON PRESENTATION OF A COMMON DISEASE AS PUO

2020 ◽  
pp. 51-52
Author(s):  
Y.V.S. Prabhakar ◽  
Ponnaganti Vasundhara
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Unknown Origin ◽  
Common Disease ◽  
Peripheral Smear ◽  
Laboratory Findings ◽  
Pyrexia Of Unknown Origin ◽  
Uncommon Presentation ◽  
Blood Smears ◽  
Peripheral Blood Smears

We report a case of pyrexia of unknown origin in a 35 yr old male . He presented to us with fever since 2 months which was associated with chills and rigor . He is non alcoholic , non smoker . Mild Hepatosplenomegaly was found on initial physical examination. Before he was referred to our hospital, he was investigated in outside hospital . The serial Rapid Diagnostic Test and microscopic peripheral blood smears for plasmodium were negative . He was treated symptomatically . In view of non subsiding fever patient was referred to higher centre . He presented to our institute for further evaluation . His laboratory findings found pancytopenia. Bone marrow aspiration(BMA) was done. BMA showed Gametocytes of P. falciparum. The presence of gametocytes of P.Falciparum in the bone marrow ,not in peripheral smear and presenting as PUO is rare .

scholarly journals Hypergranular promyelocytic leukemia (APL): cytogenetic and ultrastructural specificity

Blood ◽  
1978 ◽  
Vol 52 (2) ◽  
pp. 272-280 ◽  
Author(s):  
JR Testa ◽  
HM Golomb ◽  
JD Rowley ◽  
JW Vardiman ◽  
DL Jr Sweet
Keyword(s):  
Bone Marrow ◽  
Light Microscopy ◽  
Peripheral Blood ◽  
Promyelocytic Leukemia ◽  
Ultrastructural Evidence ◽  
Transmission Electron ◽  
Blood Smears ◽  
Cytogenetic Analyses ◽  
Peripheral Blood Smears ◽  
Ultrastructural Findings

Abstract Cytogenetic and ultrastructural findings were important diagnostic indicators of hypergranular promyelocytic leukemia (APL) in a patient whose bone marrow morphology appeared, by light microscopy, to be similar to that in acute myeloblastic leukemia (AML) with maturation. Peripheral blood smears and bone marrow specimens examined by light microscopy showed few cells with the numerous coarse, azurophilic granules typical of APL. Cytogenetic analyses, with several banding techniques, of cells from bone marrow and unstimulated peripheral blood revealed the 15;17 translocation, which has been observed only in APL. A reinterpretation of the reciprocal translocation, based on R banding, suggests that the breakpoints are distal to q24 in No. 15 and at or near the junction of q21 and q22 in No. 17. In addition, the patient had disseminated intravascular coagulation. The characteristic morphology of granules seen in APL was observed in this case only when transmission electron microscopy was used, since the granules were quite small. Since treatment for AML differs from that for APL, identification of the 15;17 translocation and ultrastructural evidence of granules represent valuable diagnostic aids for APL.

scholarly journals Novel Thyrointegrin αvβ3 Antagonist for the Treatment of Acute Myeloid Leukemia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4068-4068
Author(s):  
Shaker A Mousa ◽  
Thangirala Institute Sudha ◽  
Kavitha Godugu ◽  
Mehdi Rajabi ◽  
Nazeer Tipu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukemia ◽  
Acute Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Leukemic Cells ◽  
Blood Smears ◽  
Equity Ownership ◽  
Peripheral Blood Smears ◽  
Acute Myeloid

Abstract Acute myeloid leukemia accounts for up to one-third of the more than 60,000 leukemias diagnosed annually in the U.S. Primary AML cells express membrane αvβ3 integrin, which is associated with adverse prognosis and resistance to chemotherapies used in AML. A macromolecule Polyethylene glycol-conjugated bi-TriAzole Tetraiodothyroacetic acid (P-bi-TAT) acts with high affinity (Ki 3.1 nM) and specificity for the thyrointegrin αvβ3 receptors, without nuclear translocation and has demonstrated effective suppression of cancer cell proliferation, NF-kB expression and invasion in leukemic cells. We evaluated P-bi-TAT in two different AML models against two forms of acute leukemia (monocytic and myelocytic) that are largely resistant to existing therapy, by grafting human leukemia cells in immunocompromised male and female mice. IVIS imaging scans revealed that leukemic colonies were extensively established in bone marrow throughout the control (untreated) grafted animals, as well in liver, lung and kidney. Smears of bone marrow aspirates from untreated animals were found to contain multinucleate myeloblast and monoblast leukemic cells, and peripheral blood smears contained blast cells, multinucleated megakaryocytes, giant platelets and platelet aggregates, which are hallmarks of acute leukemia. IVIS imaging scans revealed 95% reduction in bone marrow colonies and resolution of liver, kidney and lung colonies in animals treated with P-bi-TAT at daily doses ranging from 1-10 mg/kg, subcutaneously for 2-3 weeks. Peripheral blood smears from treated animals were normal. Normal myeloblasts, which are the source of functional white blood cells, were found in the marrow smears, but leukemic cells were not detected in P-bi-TAT treated animals. Thus, against two forms of leukemia models, P-bi-TAT was extraordinarily effective, with the potential in treating most AML sub-types because αvβ3 receptors are expressed in the majority of AML. Among genes targeted by multiple laboratories for pharmacological downregulation of expression in AML are BCL2, VEGF, AKT1, KIT, IDH2, CDK4/6, TIMP1, VEGF, EGFR, and PD-L1. In that regard, P-bi-TAT has been shown in various tumor cell models to downregulate transcription of each of the genes listed, which are relevant to AML disease progression. Additionally, the pro-apoptotic P53 gene transcription is enhanced by P-bi-TAT. In conclusion, P-bi-TAT is a promising lead clinical candidate that warrants clinical trials in AML patients. Disclosures Mousa: NanoPharmaceuticals LLC: Equity Ownership, Patents & Royalties. Davis:NanoPharmaceuticals LLC: Employment, Equity Ownership.

scholarly journals REFRACTORY ANEMIA AND PANCYTOPENIA AS PRESENTATIONS OF FALCIPARUM MALARIA IN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN

2020 ◽  
Vol 17 (3) ◽  
pp. 75-80
Author(s):  
Zafar Hayat ◽  
Inam Ullah ◽  
Khizar Hayat ◽  
Hashimuddin Azam Khan ◽  
Fazle Raziq ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Falciparum Malaria ◽  
Bone Marrow Examination ◽  
Refractory Anemia ◽  
Clinical Scenario ◽  
Blood Smears ◽  
Group A ◽  
Antigen Tests ◽  
Group B ◽  
Peripheral Blood Smears

Background: Falciparum malaria is a common disease in our area. Apart from its classical presentation, at times it may present with refractory anemia or pancytopenia. The aim of this study was to determine the refractory anemia and pancytopenia as complications of falciparum malaria and apart from peripheral blood smears the significance of rapid antigen tests and bone marrow examination in the diagnosis of falciparum malaria. Material & Methods: The descriptive study included 200 consecutive cases of fever and refractory anemia or pancytopenia from 2011 to 2014. Stratification of patients according to the clinical scenario included Group-A having fever with refractory anemia and Group-B with fever and pancytopenia. A detailed history, thorough clinical examination, and pertinent laboratory tests were performed. All patients were treated with antimalarial drugs and followed-up for eight weeks. The pre and post treatment hematologic parameters were compared. Results: Among the 200 patients, 85 were males and 115 females. The age ranged from 15 to 55 years. Stratification of patients on clinical scenario revealed 175(87.5%) patients with fever and refractory anemia (Group-A). Among these, 125(62.5%) patients were reported smear positive for P. falciparum. In the remaining 50 smear negative patients rapid antigen tests were performed and all were reported positive. In 25 patients of Group B with fever and pancytopenia, the peripheral smear for malaria was positive only in 5 patients. In the remaining 20 cases both the peripheral blood smears and rapid antigen tests were reported negative. Bone marrow examination was planned to confirm the bone marrow suppression as the cause of peripheral pancytopenia, to exclude leukemia and to identify P. falciparum. The bone marrow examination revealed P. falciparum in all these cases. All the patients had a dramatic response to treatment with antimalarials in terms of disappearance of fever and correction of anemia and bone marrow rescue with reversal of pancytopenia to normal counts. Conclusion: Plasmodium falciparum should be considered in all cases of prolonged fever with refractory anemia or pancytopenia in malaria endemic areas, even with negative smear and rapid antigen tests. Bone examination is mandatory for the diagnosis in such cases. There is dramatic response of such patients to treatment with antimalarial drugs and hematinics.

scholarly journals A Preliminary Study of the Suitability of Archival Bone Marrow and Peripheral Blood Smears for Diagnosis of CML Using FISH

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Alice Charwudzi ◽  
Edeghonghon E. Olayemi ◽  
Ivy Ekem ◽  
Olufunmilayo Olopade ◽  
Mariann Coyle ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Molecular Diagnosis ◽  
Peripheral Blood ◽  
Peripheral Blood Smear ◽  
Full Blood Count ◽  
Interphase Fish ◽  
Genetic Abnormalities ◽  
Blood Smears ◽  
Peripheral Blood Smears ◽  
Cytogenetic Technique

Background.FISH is a molecular cytogenetic technique enabling rapid detection of genetic abnormalities. Facilities that can run fresh/wet samples for molecular diagnosis and monitoring of neoplastic disorders are not readily available in Ghana and other neighbouring countries. This study aims to demonstrate that interphase FISH can successfully be applied to archival methanol-fixed bone marrow and peripheral blood smear slides transported to a more equipped facility for molecular diagnosis of CML.Methods.Interphase FISH was performed on 22 archival methanol-fixed marrow (BM) and 3 peripheral blood (PB) smear slides obtained at diagnosis. The BM smears included 20 CML and 2 CMML cases diagnosed by morphology; the 3 PB smears were from 3 of the CML patients at the time of diagnosis. Six cases had knownBCR-ABLfusion results at diagnosis by RQ-PCR. Full blood count reports at diagnosis were also retrieved.Result.19 (95%) of the CML marrow smears demonstrated theBCR-ABLtranslocation. There was a significant correlation between theBCR-ABLtranscript detected at diagnosis by RQ-PCR and that retrospectively detected by FISH from the aged BM smears at diagnosis (r=0.870;P=0.035).Conclusion.Archival methanol-fixed marrow and peripheral blood smears can be used to detect theBCR-ABLtranscript for CML diagnosis.

Report of Two Cases of Microangiopathic Haemolytic Anaemia Associated with Mucinforming Gastric Adenocarcinoma

1973 ◽  
Vol 59 (3) ◽  
pp. 181-191 ◽  
Author(s):  
Gualtiero Büchi ◽  
Roberto Navone
Keyword(s):  
Bone Marrow ◽  
Gastric Adenocarcinoma ◽  
Haemolytic Anaemia ◽  
Bone Marrow Metastasis ◽  
Microangiopathic Haemolytic Anaemia

Two cases of microangiopathic erythroblastic haemolytic anaemia are reported. In both of them mucinous gastric adenocarcinoma and bone marrow metastasis were present. The patients also showed hepatic and splenic haematopoiesis. In one of these cases neoplastic pulmonary microembolisation was demonstrated. The pathogenesis of both erythroblastosis and microangiopathic haemolisis are discussed.

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