A Case with Pancytopenia: The Role of Cytomorphology
Abstract: A 63-year year old
lady presented with prolonged fever, frequent abdominal pain and a history of
melena. Physical findings revealed an anemic appearance and splenomegaly. She
was treated by the gastroenterologist and subsequently referred to the hematologist
as the peripheral blood count revealed pancytopenia with a hemoglobin level of
6.5 g/dl, WBC 4000/ uL and a platelet count of 50.000 /uL. No blast cells were
found. Patient subsequently underwent a marrow aspiration.
Cytomorphology assessment of the marrow specimen revealed the presence of
abnormal megakaryocytes and leukocytes (see figures) which was in accordance
with dyshematopeosis, and the diagnosis of MDS (myelodysplatic syndrome) was
established.
The patient was then started on thalidomide 100 mg daily. There was no
significant complications nor side-effects and after almost 2 years her
hemoglobin level is now normal (between 12 and 14 g/dl), a dramatic reversal of
her condition.
Author: Lugyanti Sukrisman,
Nadia A Mulansari, Aru W Sudoyo
Journal Code: jpkedokterangg130285
