Figure.
Morphological features of myelodysplasia and myeloproliferation are evident. Ultrasound images of the left calf demonstrating a posterior and medial complex fluid collection (yellow arrows) consistent with a hematoma is shown (panel A). Ultrasound image of the right popliteal vein (red arrow) demonstrating circumferential thickening (yellow arrows) consistent with thrombus possibly of chronic etiology (panel B). Evidence of dyshematopoiesis is shown (panels C-E x50 magnification). Accordingly, normoblasts with irregular nuclear contours, pelgeroid neutrophils and small hypolobated megakaryocytes are seen. Features of a myeloproliferative neoplasm includes presence of large megakaryocytes with so called “staghorn nuclei” (panel F X 50 magnification) showing loose cellular aggregates (trephine H&E, X20 and CD61 X10 magnification). Two ring sideroblasts are shown (panel I, Perl’s Prussian blue stain for iron X 100 magnification).