THE HISTOLOGICAL OVERVIEW TO MYELODYSPLASTIC SYNDROMES: EVALUATION OF BONE MARROW SMEARS AND BIOPSIES

Objectıve: Myelodysplastic syndromes (MDS) are clonal haematopoietic stem cell diseases characterized by one/multilineage cytopenias and dysplasia in one or more of cell lineages. The common pathological manifestations of dysplasia are nuclear fragments and multinuclearity of erythroid cells, hypogranulation/ hyposegmentation of the granulocytes, and micromegakaryocytes. We aimed to group the dysplastic features in MDS to organize a useful,schematic approach for pathologists to achieve the accurate diagnosis.

Methods: The demographical and histomorphological features of BM aspirates and BM biopsies of 40 MDS cases diagnosed according to WHO criteria were revised and regrouped. The cellularity of BM biopsy and the percentage of blasts in aspirates and biopsies, confirmed by CD34 immunostaining, were compared and noted.

Results: Twenty two female (55%) and 18 male (45%) patients with a mean age of 69.17 were included. The mean cellularity of biopsies was 49.2%. The highest dysplastic lineage was erythroid lineage (75%, n:30) in aspirates and the most common dysplastic features were nuclear abnormalities and binuclear erythroid cells. However, megacaryocytic lineage was the highest dysplastic lineage in biopsies (70%, n:28) and the most common dysplastic feature was found as hypolobulation/ monolobulation. The mean percentage of blastic cells was 2.55 in aspirates and 3.62 in biopsies.

Conclusıon: The most common dysplastic lineages and features should be remembered and investigated on every BM aspirate and biopsy by every hematologist and hematopathologist in order to reach an accurate diagnosis of MDS.