Promyelocyte, myelocyte,
metamyelocyte, band and mature neutrophil forms were absent.
BM Aspirate from a patient with Megaloblastic Anaemia showing Megaloblastic Erythropoiesis and a Giant
Metamyelocyte. Leishman Stain x40
In case of malaria infection, multiple gray dots in the middle area were observed in the IMI channel despite the absence of immature granulocytes (myelo- and
metamyelocyte) and any fluorescent signals above neutrophils in DIFF channel.
Maturation stages in the bone marrow are as follows: stem cell, myeloblast, promyelocyte, myelocyte,
metamyelocyte, band and neutrophil.
Laboratory findings reveal a normal WBC count with a left shift; 73 neutrophils, 16 bands and 1
metamyelocyte. ESR and CRP are both elevated at 38 and 12.40 respectively.
The present study also indicates that LD body may also be present inside nonhistiocytic cells like polymorph,
metamyelocyte, and therefore vigilant search of the parasite in nonhistiocytic cells should also be done (Figure 4).
A complete blood count (CBC) following his autologous stem cell transplant showed: white blood cell (WBC), 7.9 x [10.sup.3]/uL (7.9x[10.sup.9] /L); red blood cell (RBC), 3x[10.sup.6] /uL (3x[10.sup.12]/ L); hemoglobin, 9.3 g/dL (93g/L); platelet 176,000/uL (176 x[10.sup.9]/L); neutrophils, 3,700/uL (3.7x[10.sup.9]/L); bands, 700/uL (0.70x[10.sup.9] /L); lymphocytes, 1,650/uL (1.65 x[10.sup.9] /L; monocyte, 1,580/uL (1.58x[10.sup.9] /L); and
metamyelocyte, 230/uL (0.23x[10.sup.9]/L).
Photomicrograph of Megaloblastic Anaemia; aspirate shows Megaloblasts with Sieve-Like Chromatin and Giant
Metamyelocyte (Leishman Stain 1000x).
[1] Giant
metamyelocyte and stab forms were noted in 10 cases of megaloblastic anaemia.
(%)
Metamyelocyte, 1 (1.92) 1 (0.54) 1 (1.41) myelocyte, promyelocyte Blast 0 (0.00) 0 (0.00) 0 (0.00) Atypical lymphocyte 1 (1.92) 4 (2.17) 2 (2.82) NRBCs 1 (1.92) 0 (0.00) 1 (1.41) RBC morphology 7 (13.46) 121 (65.76) 17 (23.94) Platelet morphology 42 (80.77) 55 (29.89) 48 (67.61) WBC morphology 0 (0.00) 3 (1.63) 1 (1.41) Total No.
In the aspiration smear, 18% myelocyte, 35%
metamyelocyte, 11% polymorphonuclear leukocyte, 28% lymphocyte, 2% normoblast, 1% monocyte, 1% eosinophil, and 4% lymphoblast-like cells were present.
Immature neutrophils include promyelocyte myelocyte,
metamyelocyte and band form.