BM biopsy (clot) to 74yrs male was performed. CLIN. INFO: Philadelphia chromosome (-), splenomegaly, pancytopenia, Hb 96 g/, Platelets 21, leukocytes 8,0 without left shift, the lack of normoblasts. BM aspirate with expanded granulopoesis with left shift, megakaryocytosis, single micromegakaryocytes. There are any skin rush.
CLIN DGN: IDIOPATIC MYELOFIBROSIS?
HISTO: on photos bellow.
IH: spindle, "epithelioid" clear cells with ovoid nuclei are CD117+++, CD68+ (I've not mast cell tryptase).
PROPOSED DIAGNOSIS: Chronic myloproliferative disease (cellular myelofibrosis?) with systemic mastocytosis vs systemic mastocytosis only.