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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do the following bone marrow test results suggest?

Sir I am Alexpandi, age 35. In the last month I went to hospital for Hernia operation. But the results showed that platelets are 19000 only. Hence I have taken Bone Marrow Test and the results showed the following Biopsy shows predominantly cartilage and few normocellular. The megakaryocytes mildly increased that show predominantly normal morphology. The myeloid and erythroid lineages are adequate and predominantly represented. There is no evidence of leukemia and malignancy. IMPRESSON. MARROW SHOWS INCREASED MEGAKARYOCYTES - CONSISTENT ITB . Now I taking steroids tablets like Predinosolone 60 mg, Pan40mg and Flucon 50mg for two weeks. Now the platelet level is 55,000 to 65,000 only. There is no improvement. Please tell me the treatment and health food for increase to 1,50,000. Previously I am a smoker but now i quite from smoking.. Thank you....
Fri, 5 Oct 2018
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Pathologist and Microbiologist 's  Response

You are suffering from idiopathic thrombocytopenic purpura. The treatment is Prednisolone that you are already on.

Hope I have answered your query. Let me know if I can assist you further.

Dr. Peeyush Kumar Saini,
Pathologist and Microbiologist
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doctor1 MD

I had a bone marrow biopsy done and I would like to know some information regarding the Aspirate Smear, here is what it said. Quality: Adequate, Cellularity: Cellular, Myeloid lineage: Synchronous and progressive, Erythroid lineage: Synchronous and progressive, Megakaryocytes: Occasional. Normal morphology. Is it normal to have Megakaryocytes in a bone marrow aspirate? Here was the differential: Blasts 0%, Promyelocytes 2%, Myelocyte/Meta 38%, Neutrophil 15%, Eosinophils 2%, Erythroid 27%, Lymphocytes 14%, Plasma cells 2%. M:E ratio 3:1, what does that mean and is it normal? Is it normal to have Promyelocytes and are all the percentages within normal ranges? Core Biopsy: Quality: Suboptimal (short core biopsy). Bone/soft tissue: Normal, Cellularity: Unable to determine but specimen is approximately 40%. Myeloid lineage: Progressive. Erythroid lineage: Progressive. Megakaryocytes: Occasional megakaryocytes with normal morphology. Others: No increase blasts or lymphoid aggregates. What does approximately 40% mean on Cellularity? Also had Special Stains: Aspirate smear Iron stain: No Histiocytic and sideroblastic iron (0/4). Core biopsy, Iron: No stainable iron. I was having Phelbotomies prior to this bone marrow test because I was given too much iron supplement, and my iron became depleted so it seems. My ferritin level at the time of the bone marrow biopsy was only 7. So is it normal to have Megakaryocytes in bone marrow aspirate, I megakaryocytes should only be in the bone marrow, not the aspirate, can you clarify this for me. And are Promyelocytes normal in the aspirate? Is the ratio normal 3:1? And is Cellularity 40%, is that normal? Would greatly appreciate your expertise opinion, thank you.

doctor1 MD

Dear Dr puthillath. I will get right into my issues. I have had several years now of leukocytosis ranging from 14000-30000 I am 38 years old and have always not felt myself, I get tired easily and can catch colds easily. I had a bone marrow biopsy done several years ago but results not called or followup so I thought everything was ok. I just recently had lower back, groin and hip pain. also intermittent left rib pain, not excrutiating but a gnawing pain. I got my past results from hospitals including biopsy results. I would like to know if you can explain these results to me and see if it should be followed up even though they are several years later. Bone Marrow results-This is not a full report but gave some info. Cellularity5 50% estimated E:R4.1, with progressively maturing mildly dysplastic granulopoeisis and hypochromic erythropoesis. adequate megakaryocytes and mild plasmacytosis also decreased stainable iron. Blood Smear- mild anisopoikilocytosis with hypochromia and many target calls. There were rare tear drop forms. WBC showed many hypersegmented polys which were macrocytic. There were rare myelocytes present. Platelets normal. If you can please break this down for me and let me know what it means it would be great! Thanks, Melissa

doctor1 MD

Hello sir/madam Am sending u the reports of my father who is suffering from kidney failure and is on haemodialysis since 1 year. As his Haemoglobin is 7.5 only. He is continously taking Erythropoietin injections twice a week past 1 year. Their is no improvement in his haemoglobin content. As suggested by doctor we have done bone marrow tests. Pls go thru the reports and suggest what blood disease he is suffering from: The reports of Bone marrow tests are as follows: Red cells show moderate anisopoikilocytosis, microcytic hypochromic with a afew tear drop cells and target cells, occasional fragmented cells seen. Leucocytes are normal. Neutrophils 70%, Lympocytes 23%, monocytes 3%, eosinophils 4%. Platelets are adequate. Bone marrow: Aspiration: Particulate smears with cellular trails. Blasts are 7% of marrow nucleated cells. Myeloid precursors show mild dyspoeisis, there is erythroid prominence. Erythropeisis is normoblastic. ME ratio is reversed and 1:1.2. megakaryocytes are adequate, few dyspoeitic forms are seen. Perls stain shows increased iron stores. No ring sideroblasts seen. Biopsy imprints show few cellular foci. Thanking you