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Old Sat Mar 12, 2016, 04:55 PM
Baileyshome7 Baileyshome7 is offline
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Join Date: Mar 2016
Location: Keyser, WV
Posts: 3
Thoughts please. Could this be serious

Hi,
I have been having problems with low platelets for a long time. In recent months they have been decreasing even more. I had a bone marrow biopsy on 3/4/16 and my platelets had decreased to 74, from 79 a month before.

I do have a diagnosis of sarcoidosis from 2001. And type 2 diabetes of about 7 years. My liver and spleen are enlarged.

Is there anyone who can help me just from thoughts on my biopsy report. I'm just trying to figure out if it looks like something may be going on.

I will paste results below, thanks in advance.

Results: Identifying info has been removed for privacy:

PATH CONS 7740 | REPORT | | () 03/12/16-0756
|
| TESTS: Consult (1)
| SS-Misc (2)
| PAX-5, IHC with Interp (1)
| HISTOPATHOLOGY TISSUE/CONSULT (1)
| CD61,IHC w/ interp (1)
| CD34,IHC w/ interp (1)
| CD3,IHC (1)
CLINICAL DIAGNOSIS / INFORMATION:
Interpretation of Submitting Facility (PRELIMINARY): Mildly
hypocellular bone marrow with maturing trilineage
hematopoiesis
SITE OF BIOPSY / SOURCE:
Block/slides - 16BM-37-A1,B1 Bone marrow, left hip (2 blks,
| 7 stnd
| slds, 1 H#E, 8 smears)
| GROSS DESCRIPTION:
| Received are two paraffin-embedded tissue blocks, 1 H#E, 7
| unstained
| slides and 8 smears labeled 16BM-37-A1,B1.
| PERIPHERAL BLOOD - CBC REPORT
| WBC: 4.0 K/uL
| RBC: 5.18 M/uL
| HGB: 15.8 g/dL
| HCT: 46.6 %
| MCV: 90.0 fL
| MCH: 30.6 pg
| MCHC 34.0 g/dL
| RDW: 14.2 %
| PLT: 74 K/uL
| DIFFERENTIAL (AUTOMATED):
| NEUTROPHILS: 66.3 %
| LYMPHOCYTES: 22.8 %
| MONOCYTES: 8.1 %
| EOSINOPHILS: 2.2 %
| BASOPHILS: 0.6 %
| MICROSCOPIC DESCRIPTION:



PERIPHERAL BLOOD: A peripheral blood smear is not received for review.
| BONE MARROW, CORE BIOPSY: The biopsy shows focal marrow
| drop-out,
| somewhat limited for morphologic evaluation. Cellularity is
| estimated at (-20-30%), hypocellular marrow for age.
| Maturing myeloid and erythroid precursors are present.
| Scattered megakaryocytes are seen. There is no lymphoid
| aggregate or metastatic tumor identified.
| BONE MARROW, ASPIRATE CLOT: Sections contain few small
| marrow
| particles, morphologically similar to the core biopsy.
| BONE MARROW, ASPIRATE: Wright-Giemsa stained aspirate
| smears are
| reviewed. They contain a few small cellular spicules,
| adequate for evaluation. Myeloid precursors appear to show a
| full range of maturation with mild left-shift. Erythroid
| precursors show a full
| range of maturation. The M:E ratio is within normal range.
| Scattered
| megakaryocytes are seen, which are mostly unremarkable in
| morphology. There is no increase in blasts or lymphocytosis.
| Scattered plasma
| cells are noted. A 300-cell differential count is: 2%
| blasts, 58%
| myeloid cells, 28% erythroid precursors, 6% lymphocytes, 3%
| eosinophils, 1% monocytes, and 2% plasma cells.
| SPECIAL STAINS: A submitted iron stain shows the presence
| of storage
| iron. Ring sideroblasts are not identified. A submitted
| reticulin stain shows focal, very mild reticulin fibrosis.
| IMMUNOHISTOCHEMISTRY: Submitted CD138 and CD34 stains were
| reviewed.
| CD34, CD61, CD3 and PAX-5 were performed in-house. Controls
| stained appropriately. CD34 shows no increase in blasts.
| CD61 stains scattered megakaryocytes, mildly decreased or
| borderline adequate in number. CD3 stains low level
| interstitial T-cells. PAX-5 stains
| scattered B-cells. CD138 stains occasional plasma cells
| (<5%).
| -------------------------- FINAL DIAGNOSIS

| BONE MARROW, CORE BIOPSY, ASPIRATE AND ASPIRATE CLOT
| (16BM-37-A1, B1):
| - HYPOCELLULAR MARROW (-20-30%) WITH TRILINEAGE
| HEMATOPOIESIS - STORAGE IRON PRESENT - SEE MICROSCOPIC
| DESCRIPTION AND COMMENT
| QL/STR
| COMMENTS:
| The provided CBC data show mildly elevated hemoglobin
| level/RBC count and thrombocytopenia.
| The concurrent flow cytometric analysis (CH116574I) revealed
| no atypical findings. Cytogenetic analysis showed normal
| karyotype.
| Morphologic examination demonstrates a hypocellular marrow
| for age with trilineage hematopoiesis. Megakaryocytes are
| borderline adequate or mildly decreased in number.
| Significant dyspoiesis is not observed. Secondary causes for the thrombocytopenia should be evaluated. In addition, the
| significance of the mildly elevated RBC count/hemoglobin
| level is uncertain. Clinical correlation and close follow up
| are recommended.
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