Pathology
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Atlas of Bone Marrow pathology
Mojmir Moulis, Josef Feit et al.
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+ Bone Marrow Pathology
+ Bone Marrow Examination
+ Bone Marrow Examination
+ Histological evaluation of the trephine biopsy core
+ Normal bone marrow
+ Bone Marrow Cellularity
+ Hematopoiesis
+ Non-tumorous Lesions of Bone Marrow
+ Reactive Hematopoietic Changes
+ Erythroid hyperplasia
+ Myeloid Hyperplasia
+ Eosinophilia
+ Increased Number of Megakaryocytes
+ Bone Marrow Hypoplasia and Aplasia
+ Aplastic Anemia
+ Pure red cell aplasia
+ Agranulocytosis
+ Amegakaryocytic thrombocytopenia
+ Anemias
+ Posthemorrhagic anemias
+ Acute Posthemorrhagic Anemia
+ Chronic Posthemorrhagic Anemia
+ Megaloblastic Anemia
+ Sideropenic Anemia
+ Chronic Kidney Disease Anemia
+ Anemias of Chronic Disorders
+ Hemolytic Anemias
+ Other anemias
+ Stromal Reaction and Bone Marrow Inflammation
+ Reactive lymphocytosis, benign lymphocytic aggregates
+ Reactive Plasmacytosis
+ Granulomas
+ Hemophagocytic Syndrome
+ Storage Diseases (Thesaurismosis)
+ Gaucher's Disease
+ Niemann–Pick Disease
+ Bone marrow tumorus diseases
+ Myelodysplastic Syndrome (MDS)
+ Refractory Cytopenia with Unilineage Dysplasia (RCUD)
+ Refractory Anemia with Ringed Sideroblasts (RARS)
+ Refractory Cytopenia with Multilineage Dysplasia (RCMD)
+ Refractory Anemia with Excess Blats (RAEB)
+ MDS with Isolated 5q Deletion (5q-syndrome)
+ Myelodysplastic Syndrome Unclassified (MDS NOS)
+ Myeloproliferative neoplasms
+ Polycythemia Vera (PV)
+ Essential Thrombocythemia (ET)
+ Primary Myelofibrosis (PMF)
+ Chronic Myeloid Leukemia (CML)
+ Chronic Neutrophilic Leukemia (CNL)
+ Chronic Eosinophilic Leukemia (CEL)
+ Mastocytosis
+ MPN unclassifiable (MPN-U)
+ Myelodysplastic-myeloproliferative diseases (MDS/MPD)
+ Chronic Myelomonocytic Leukemia (CMML)
+ Atypical Chronic Myeloid Leukemia (aCML)
+ Juvenile Myelomonocytic Leukemia (JMML)
+ Myelodysplastic-Myeloproliferative Diseases Unclassifiable
+ Acute Myeloid Leukemia (AML)
+ Lymphoproliferative Disorders
+ Acute Lymphoblastic Leukemia (ALL)
+ Chronic Lymphocytic Leukemia (CLL)
+ Prolymphocytic Leukemia (PLL)
+ Hairy cell leukemia (HCL)
+ Plasma Cell Neoplasms
+ Plasma Cell (Multiple) Myeloma
+ Solitary Plasmocytoma
+ Monoclonal Gammapathy of Undetermined Significance (MGUS)
+ Other Lymphoproliferative Diseases
+ Histiocytoses
+ Histiocytosis X (Langerhans Cell Histiocytosis)
+ Letterer-Siwe Histiocytosis
+ Hand-Schüller-Christian Histiocytosis
+ Eosinophilic Granuloma
+ Histiocytic Sarcoma
+ Metastatic Infiltration of the Bone Marrow
+ Posttheraupetic a Posttransplant Hematopoietic Changes
+ Posttheraupetic Hematopoietic Changes
+ Restitution of Hematopoiesis
+ Persistent Alterations of Hematopoiesis.
+ Posttransplant Alterations of Hematopoiesis
+ Pathology of the Bone
+ Other Disorders
Myelodysplastic Syndrome (MDS)
Introduction

A collection of clonal disorders affecting hematopoietic stem cells. It is characterised by dysplastic changes in one or more lineages and ineffective hematopoiesis.

Etiology

De novo origin or following exposure to toxins (including certain chemotherapeutics), ionizing radiation or association with some hematological diseases (for example Fanconi anemia).

Clinical signs
  • age: primarily elderly patients (median is 70 years of age)
  • incidence 3/100.000, 20/100.000 among 70-year olds
  • anemia — weakness, paleness, dyspnoea
  • neutropenia — opportune infections
  • thrombocytopenia — increased susceptibility to bleeding
Classification

WHO 2008:

  • Refractory cytopenia with unilineage dysplasia (RCUD)
  • Refractory anemia with ringed sideroblasts (RARS)
  • Refractory cytopenia with multilineage dysplasia (RCMD)
  • Refractory anemia with excess blasts (RAEB)
  • MDS with isolated 5q deletion (5q-syndrome)
  • MDS unclassified (MDS-U)
Histology
  • Structural features:
    • bone marrow is usually hypercellular
    • distorted architecture:
      • clusters of megakaryocytes
      • peritrabecular erythropoiesis
      • dispersed erythropoietic islands
      • ALIP (abnormal localisation of immature precursors) myelopoiesis phenomena
  • Cytological features:
    • megakaryocytes: hypolobated or hyperlobated nuclei, hyperchromia, micromegakaryocytes
    • erythropoiesis: megaloblastic changes, bizzare nuclear shapes, nuclear budding, internuclear bridges, polynucleated cells, cytoplasmic vacuolization, ringed sideroblasts
    • granulopoiesis: nuclear hypolobation (pseudo–Pelger-Huet anomaly), nuclear hypersegmentation, hypogranular cytoplasm