This patient went on to have a bone marrow aspirate.
- Cellularity: A markedly hypercellular marrow trephine with significant architectural distortion, paratrabecular fibrosis and marrow necrosis with areas of cellular ghosting.
- Bony trabeculae: Markedly thickened.
- Erythropoiesis: Markedly reduced in amount.
- Granulopoiesis: Moderately increased in amount with evidence of progression to segmented forms.
- Megakaryocytes: Normal in number and morphologically normal.
- Lymphocytes: Normal in number with no significant aggregation or clustering.
- Foreign cells: Nil seen.
- Other cells: Excess of mast cells in a paratrabecular distribution in conjunction with the fibrosis. Many of these appear round in nature and are noted to form clusters and aggregates. Additional cells are noted to be spindle-shaped in keeping with abnormal mast cells.
A markedly hypercellular marrow trephine with significant paratrabecular fibrosis and an excess of abnormal mast cells. These features are in keeping with ongoing marrow involvement with mastocytosis.