Highly hypercellular, atypical bone marrow with myeloid maturation defects, left shifted atypical erythropoiesis and atypicality of the megakaryocytes. The histopathology (HE) and the clinics is suggestive of severe reactive process (hemolysis? paraneoplasia - e.g. myelopathy in mesothelioma or liver cancer? virus- (Parvo B19??) or other infection - indeed in one of the mircophotographs - P3240118 - there are some incluisins that have to be closer studied with respect to Leishmania), but a myeloid neoplasm (MDS, MDS/MPN, u) is not completely excluded, which requires some additional analyses: Gömöri staining to asses myelofibrosis, Giemsa to look for Donovan bodies, CD34 stianing to asses blasts, Parvo B19, analysis of the smear (PB and BM), lab indicators of hemolysis - LDH, bilirubin, haptoglobin?

Thank you, let me order for the tests