Page 192 - Clinical Hematology Atlas
P. 192

176    SECTION FOUR  LEUKOCYTES

                                        PRIMARY MYELOFIBROSIS
























              A                                          B
            FIGURE 17–5A  Peripheral blood (31000; subtle   FIGURE 17–5B  Peripheral blood (31000; more
            changes).                                  advanced case).


                 MORPHOLOGY
                 Peripheral Blood:
                    LEUKOCYTES
                    Normal, increased, or decreased

                      •  Immature granulocytes
                      •  ,5% blasts
                    ERYTHROCYTES
                    Normal or decreased
                      •  Tear drop cells common, nucleated erythrocytes, polychromasia
                    PLATELETS
                    Low, normal, or increased
                      •  May be giant with atypical shapes
                      •  Abnormal granulation
                      •  6 Circulating micromegakaryocytes
                 Bone Marrow:  Aspiration attempts often result in a dry tap; biopsy results exhibit marked
                    fibrosis with islands of hematopoietic activity and pockets of clumped megakaryocytes.
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