Acute myeloid leukemia was established after multiple bone marrow biopsies in a child with cytopenia and bone marrow fibrosis (IMAGE)

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Acute myeloid leukemia was established after multiple bone marrow biopsies in a child with cytopenia and bone marrow fibrosis

Caption

(a)-(d): The bone marrow biopsy shows mild hypercellularity (a, H&E 200×) and mild to moderate fibrosis (b, Reticulin stain, 200×). CD79a (c, 200×) and CD3 (d, 200×) immunostains highlight lymphoid aggregates with B and T lymphocytes. (e)-(h): The second bone marrow biopsy shows patchy cellularity (e, H&E 200×) and severe fibrosis (f, Reticulin stain, 200×). CD61 (g, 200×) immunostain highlights scattered megakaryocytes, including rare small ones; CD117 (h, 200×) immunostain is mostly negative. CD34 was negative (not shown). (i)-(l): The third bone marrow biopsy shows patchy low cellularity (i, H&E 200×) and mild to moderate fibrosis (j, Reticulin stain, 200×). CD61 (k, 200×) immunostain highlights many megakaryocytes, including small ones; CD117 (l, 200×) immunostain is mostly negative. CD34 was negative (not shown). The patient then received chemotherapy. (m)-(p): The fourth bone marrow biopsy shows patchy hypercellularity (m, H&E 200×) and moderate fibrosis (n, Reticulin stain, 200×). CD61 (o, 200×) immunostain highlights very rare megakaryocytes; CD117 (p, 200×) immunostain highlights numerous blasts. CD34 was negative (not shown). H&E, hematoxylin and eosin.

Credit

Jinjun Cheng

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