Bone marrow finding in myelofibrosis ?
Ans. is 'a' i.e., Dry tap (hypocellular)Mvelofibrosis o The hallmark of primary myelofibrosis is rapid development of obliterative marrow fibrosis.o Myelofibrosis suppresses bone marrow hematopoiesis, leading to peripheral blood cytopenias.o This results in extensive extramedullary hematopoiesis in the spleen, liver and lymphnode Splenomegaly and hepatomegaly.o Blood cell production from sites of extramedullary hematopoisis is disordered and ineffective --> Persistent cytopenia. Peripheral blood picturei) Leukoerythroblastosis Presence of erythroid and granulocytic precursors in the peripheral blood.ii) Tear-drop erythrocytes (dacrocytes) --> Fibrotic marrow distos and damages the membranes of erythroid proginators.Bone marrow findingso Initially marrow is hypercellular.o With progression marrow becomes hypocellular and diffusely fibrotic ---> Bone marrow aspiration is a dry tap. o There is increase laying down of reticulin fibril network.o Cellularity of bone marrow is decreased, but megakaryocytes are increased and demonstrate features of dysmegakaryopoiesis.o Dilated marrow sinusoids.
Dry tap (hypocellular)
Megaloblastic cells
Microcytic cells
Thrombocytosis