refractory cytopenia with multilineage dysplasia


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  • Clinical

    • 30% of MDS
    • median age 70
    • marrow failure, cytopenia of 2+ myeloid lines

  • Morphology

    • dysplasia in 2+ lineages
      • neutrophils
        • hypogranulation
        • hyposegmentation
        • pseudo Pelger Huet (chromatin clumping)
      • erythroid
        • cytoplasmic vacuoles
        • nuclear irregularity
        • internuclear bridging
        • multilobation
        • nulcear budding
        • multinucleation
        • megaloblastoid
        • can have ring sideroblasts
      • megakaryocyte
        • hypolobation, nonlobation
        • multinucleate
        • micromegakaryoytes
    • blasts < 1% in blood, < 5% in marrow
    • marrow: hypercellular, can have markedly elevated erythroids
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