April 2019 — Anatomic and Clinical Pathology 2

An 82-year-old male with well-controlled HIV and macrocytic anemia undergoes a bone marrow biopsy. The morphologic findings are subtle, including few slightly atypical eosinophils on peripheral blood, mild granulocytic hyperplasia, a single paratrabecular cluster of eosinophils, and few spindled mast cells. There is no overall marrow or blood eosinophilia. Karyotype detects a t(4;22)(q12;q11.2) clonal abnormality involving PDGFRA (4q12) by break-apart FISH. Mate pair sequencing demonstrates a fusion between the PDGFRA and SPECC1L genes.

Peripheral Blood
Aspirate
Aspirate and IHC
Bone Marrow Core

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Photo of Daniel (Dan) P. Larson, M.D. Daniel (Dan) P. Larson, M.D.
Resident, Anatomic and Clinical Pathology
Mayo Clinic
Photo of Pedro Horna, M.D. Pedro Horna, M.D.
Senior Associate Consultant, Hematopathology
Mayo Clinic
Associate Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine
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MCL Education

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