William Aird
William Aird

@WilliamAird4

4 Tweets 12 reads Jul 31, 2023
1/4
LEUKOERYTHROBLASTIC PICTURE vs. MYELOPHTHISIS
I recently saw a 45 yo M who presented with macrocytic anemia, nRBCs, and a left shift (see CBC). His peripheral smear demonstrated bands, myelocytes and metamyelocytes, and many tear drop forms.
What is this picture called?
2/4
The two terms that come to mind are leukoerythroblastic picture and myelophthisis. I frequently make the mistake of treating these terms synonymously. However, they are have different meanings.
3/4
Leukoerythroblastic picture describes findings on a peripheral smear (think of "picture" as a smear). It consists of nRBCs and immature WBCs. Tear drops may be present but they don't have to be. The bone marrow may or not be infiltrated.
4/4
Myelophthisis, on the other hand, describes a pathophysiological process in which bone marrow is replaced by fibrosis or metastatic cancer, resulting in extramedullary hematopoiesis. It may or may not be associated with a leukoerythroblastic picture and tear drop cells.

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