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Autor*: A. Buliková
Description:
48 years old woman has been treated for ovarian cancer ( surgery, chemotherapy - taxans, carboplatinum, topotecanum) for two years. The severe bicytopenia has developed during last two months (hemoglobin 65,8 g/l, platelets 7G/l). Peripheral blood smear proves sever thrombocytopenia, but does not show any change in leukocyte differential blood count. In bone marrow are 6 - 10% myeloblasts, dysplastic changes of erythropoiesis and in megakaryocytes. Final diagnosis is myelodysplastic syndrome therapy related, refractory anaemia with excess blasts I (RAEB I).
Zařazení*:
Refractory anaemia with excess blasts I
Přílohy*:
Description: Dysplastic bi-nucleated erythroblasts (they are oxyphil with basophilic stippling, abundant cytoplasm, nuclei have different size and relatively immature chromatin). Megakaryoblast with cytoplasmic blebs is above the centre of the picture. 
Description: Early megaloblast (at right) and dysplastic late erythroblast (at left; it has non-round nucleus and basophilic stippling). Myeloblast with some azurophilic granules in Golgi zone is under the megaloblast. 
Description: In the middle of the picture is dysplastic erythroblast with mature abundant ortochomatophilic cytoplasm and irregular shape of the nucleus. Two blast, that at 11 o'clock is myeloblast with numerous azurophilic granules.
Description: Late erythroblasts - that one in the middle with atypical mitosis and Howell-Jolly body, another one (at 8 o'clock) with completely fragmented nucleus. 
Description: Two early erythroblasts and one late erythroblast, they have non-round nucleus; cytoplasmic blebs, that one at 4 o'clock is bi-nuclear. Three blasts - two of them are II. type myeloblasts with few azurhopilic granules, that lower one without any differentiating features. 
Description: Poly-nuclear form of basophilic megakaryocyte 8N (N=number of sets of chromosomes) with really immature nuclei - fine chromatin, multiple nucleoli.