Chronic Myeloid Neoplasms - Arsenic toxicity

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Chronic Myeloid Neoplasms

Myelodysplastic syndromes

Arsenic toxicity

Reviewer: Nikhil Sangle, M.D., University of Utah & ARUP Laboratories (see Reviewers page)
Revised: 25 July 2011, last major update July 2011
Copyright: (c) 2001-2011, PathologyOutlines.com, Inc.

General
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● May cause myelodysplastic changes in erythroblasts and neutrophils
● Patients present with pancytopenia and hypo/normocellular marrow with dysplastic elements
● Note: arsenic trioxide is also a treatment for myelodysplasia (Curr Hematol Rep 2005;4:59)

Case reports
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● 41 year old woman with GI and neurologic symptoms for 6 months plus pancytopenia (Am J Hematol 1991;36:291)

Micro description
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● Peripheral blood: erythrocytes show coarse basophilic stippling and karyorrhexis (Am J Clin Pathol 1984;81:533)
● Bone marrow: erythroblasts show megaloblastic changes and karyorrhexis (Blood 1975;45:241)

Micro images
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Peripheral blood images:

Erythroid precursor with slightly lobulated megaloblastoid nucleus

Bone marrow smear:

Erythroid precursors have marked dysplastic changes including nuclear lobulation and karyorrhexis

EM description
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● Megaloblastic features of high N/C ratio and nuclear-cytoplasmic dyssynchrony (Blood 1979;53:820)

End of Chronic Myeloid Neoplasms > Myelodysplastic syndromes > Arsenic toxicity

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