Leukemia - Acute
AML not otherwise categorized
Acute panmyelosis with myelofibrosis

Author: Daniela Mihova, M.D. (see Authors page)

Revised: 9 April 2018, last major update March 2013

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PubMed Search: Acute panmyelosis with myelofibrosis

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Cite this page: Mihova, D. Acute panmyelosis with myelofibrosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/leukemiapanmyelosis.html. Accessed December 19th, 2018.
Definition / general
  • Also called acute (malignant) myelofibrosis, acute (malignant) myelosclerosis, acute myelodysplasia with myelofibrosis
  • Now a distinct entity in WHO (2008) but not previously (Ann Hematol 2004;83:513, Leuk Lymphoma 2004;45:681)
  • Rare, rapid onset, aggressive, usually adults
  • Weakness, fatigue, fever, bone pain, pancytopenia; usually no marked splenomegaly
  • Median survival is 2 - 9 months
Case reports
Microscopic (histologic) description
  • Hypercellular marrow with erythroblasts, immature granulocytes, megakaryocytes
  • Prominent megakaryocytic abnormalities with variation in size and dysplastic changes, immature granulocytes with dysplasia and immature erythrocytes
  • Usually marked fibrosis (reticulin > collagen)
  • Aspirate smear is often hypocellular due to marked fibrosis
Microscopic (histologic) images

Images hosted on PathOut server:

Bone marrow smear (Wright-Giemsa):
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Numerous blasts, some CD61+,
also abnormal erythroid
and granulocyte cells

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Blasts and more mature granulocytes, also
a large megakaryocyte with a poorly lobulated
nucleus and dispersed chromatin, occasional
neutrophils and late stage erythroblasts



Bone marrow biopsy:
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Partial replacement of marrow by
blasts and increased fibrous tissue

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Numerous blasts with some clustering



Lymph node biopsy:
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Total effacement by blasts, also
scattered megakaryocytes at
various stages of maturation

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Blasts have fine chromatin and small but
distinct nucleoli, mitotic figures are present



Stains:
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Increase in coarse reticulin fibers

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Reticulin stain shows markedly
hypercellular marrow with proliferation
of blasts and maturing cells, and
increase in coarse reticulin fibers

Positive stains
Differential diagnosis