A) Peripheral blood smear with basophilia (Wright stain, 1000x oil)A) Peripheral blood smear with basophilia (Wright stain, 1000x oil)
B) Peripheral blood smear with marked basophilia (#2), (Wright stain, 1000x)B) Peripheral blood smear with marked basophilia (#2), (Wright stain, 1000x)
C) Aspicular bone marrow aspirate with scattered blasts and basophils (Wright stain, 1000x oil)C) Aspicular bone marrow aspirate with scattered blasts and basophils (Wright stain, 1000x oil)
D) Bone marrow trephine biopsy with a fibrotic appearance at low power, slight osteosclerosis and decreased overall cellularity (H&E, 100x)D) Bone marrow trephine biopsy with a fibrotic appearance at low power, slight osteosclerosis and decreased overall cellularity (H&E, 100x)
E) Bone marrow cellularity composed of fibroblasts, scattered immature mononuclear cells and decreased megakaryocytes (H&E, oil 1000x)E) Bone marrow cellularity composed of fibroblasts, scattered immature mononuclear cells and decreased megakaryocytes (H&E, oil 1000x)
F) Bone marrow reticulin fibrosis 4+/4+ (MF-3) (reticulin, 400x)F) Bone marrow reticulin fibrosis 4+/4+ (MF-3) (reticulin, 400x)
G) Bone marrow collagen fibrosis (trichrome, 400x)G) Bone marrow collagen fibrosis (trichrome, 400x)
H) Subsequently biopsied myeloid sarcoma (H&E, 1000x oil)H) Subsequently biopsied myeloid sarcoma (H&E, 1000x oil)
I) Karyogram showing 46,XY,t(9;22)(q34;q11.2)I) Karyogram showing 46,XY,t(9;22)(q34;q11.2)