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).
 Giant metamyelocyte
and stab forms were noted in 10 cases of megaloblastic anaemia.
, 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.