I agree with your description of the changes in the Pb smear.  
The bone marrow smear shows as you described a normal M:E ratio with normal maturation of the erythroid and myeloid series. Occasional megaloblastoid erythroblasts. Few morphologically normal megakaryocytes are seen. Since there are several compact marrow particles on the smear, it cannot be excluded that more megakaryocytes could be trapped within the particles. Lymphocytes are slightly increased. There is no increase in blasts and are no abnormal cells can be seen.  
In summary: The findings on the aspirate cannot explain the severe pancytopenia of this patient. There is no evidence for a primary hematologic disorder or an infiltrate by malignant cells.  
Do you have any clinical information about some underlying disease which could explain the cahnges in the Pb?  
PS: I would also suggest to perform an iron stain if you have some unstained slides left.

Peripheral smear shows (last two slides), moderate anisopoikilocytosis with a few fragmented RBCs and polychromatic cells. No leucoerythroblastic picture. BM shows hyperplasia with a few megaloblasts. With a picture of pancytopenia, this could be a case of dimorphic anemia. Meglaoblastic component may explain, pancytopenia and hemolysis.

Thank you Dr. Hurwitz an Dr. Prasad for your comments. Here in India combined deficiency of Iron and B12/Folic acid is not uncommon. Hence I have suggested iron studies and vit. B12/Folate levels or therapeutic trial. Patient has documented micro hypo anaemia with HB of 7.0 gm% 6 mths back. POssibly she has developed superimposed B12/Folate deficiency and led to this unusual picture. There is no h/o drug or chemical exposure. NO fever. No organomegaly. And no slides left for other studies. (only 2 were receved.)

I discussed the case with another very eyperienced hematologist, his view, which I fully support is that the megaloblastic component is only minimal, and the majority of findings point to a severe iron deficiency. Do you have any information as to the iron values in her serum? is there any evidence of a parasitic infestation?

Thanks Dr. Hurwitz!  
As is usually the case with most of the patients coming to me, this patient is too poor to undergo other investigations so most probably she will get a therapeutic trial and if she does not respond additional investigations will be done. I will try and give you feedback.  
warm regards..

Thanks, your feedback will be greatly appreaciated

Patient received therapy of Iron, B12/Folic acid with few Packed cell transfusions (sorry can not be more precise), today her HB was 11.3 gm%, WBC count: 5,600 Platelets: 538,000/cmm.  
Any comments?

I agree with Nina and her clinical colleague: severe pancytopenia due to combined megaloblastic anemia and iron deficiency anemia. In spite of the reduced MCV due to the iron deficiency the pics show the characteristic giant metamyelocytes and band forms of B12/folate deficiency.  
 
Megaloblastic anemia is often overlooked as a cause of pancytopenia. My friend David Savage from Columbia University wrote an interesting review on this topic (Savage et al: Pancytopenia in Zimbabwe. Am J Med Sci. 1999 Jan;317(1):22-32). He noted that normal or low MCV values were noted in almost one third of patients with megaloblastic anemia in the study.  

Thanks Attilio, this is really a good teaching case, since in our part of the world these cases are rather rare. It would be interesting get another folow-up of the PB values,after the transfusion effect has passed.