bone marrow biopsy results, i dont understand all.
 

this is what it says, i understand some, but i have no infections or other issues nor auto immune issues. I do have mcas which is a cousin to mpns.

COMMENT: This is a normocellular marrow (50% cellularity). There is trilineage hematopoiesis with a full range
of maturation. There is no increase in blasts seen by morphology, immunohistochemistry, or flow cytometry. An
increase in mast cells is not identified. Megakaryocytes do not appear atypical and are not clustered. There
appears to be mild neutrophilic atypia in the peripheral blood in the form of neutrophils with increased lobation.
Neutrophils also appear somewhat hypergranulated, and there is a mild increase in large granular lymphocytes.
Other lymphocytes appear reactive with voluminous cytoplasm and molding around adjacent red blood cells. The
findings seen in this case are nonspecific, but an infectious process can have these effects in the peripheral blood.
Infection is additionally a common cause of mild thrombocytosis. The differential diagnosis for neutrophilic atypia
when considered alone is fairly lengthy, but in addition to infection includes toxin/drug effect, autoimmune disease,
and nutritional deficiency. Usually this is accompanied by cytopenias, which this patient does not appear to exhibit,
and in that context MDS is sometimes considered. Per clinician request the following tests are pending: karyotype,
AML FISH panel, MDS FISH panel, eosinophilia/MPN FISH panel, and the myeloid molecular NGS panel.
dequate for evaluation. Evaluable marrow is approximately 0.8 cm. The cytologic detail
is optimal.
CELLULARITY: Normocellular bone marrow. The cellularity is approximately 30-40%.
M:E RATIO: The M:E ratio is estimated at 3:1.
MYELOID SERIES: Granulopoiesis shows maturation. The morphology is within normal limits.
ERYTHROID SERIES: Erythropoiesis is mostly normoblastic.
MEGAKARYOCYTES: The megakaryocytes are adequate in number. The morphology is within normal limits.
PLASMA CELLS: There are a few scattered plasma cells. Plasma cells have normal morphology.
LYMPHOID CELLS: A rare small reactive-appearing lymphoid aggregate is seen.
OTHER CELLS: Extrinsic cells are not identified.
TRABECULAR BONE: Boney trabeculae are unremarkable.

It detects trace myeloid precursors, 14% lymphocytes, 3% monocytes, 1% basophils
and 75% neutrophils.
Note: The viability of the specimen is 98%.
BLOOD SMEAR (4/28/2021)
RED BLOOD CELLS: Mild anemia with normal morphology. Microorganisms are not seen.
PLATELETS: Normal number with normal morphology. An occasional giant platelet is seen.
WHITE BLOOD CELLS: Leukocytosis with neutrophilia. Mild neutrophilic atypia is seen with hyperlobated forms
and 10% of the lineage. There appears to be toxic granulation. There is a mild increase in large granular
lymphocytes. Lymphocytes appear reactive. Microorganisms are not seen.
BLASTS: Not identified
NUCLEATED RED BLOOD CELL