Bone Marrow Aspirate showing megaloblastic erythropoeisis with very fine nuclear chromatin and asynchrony of development of nucleus (immature) and cytoplasm (more mature).
Bone marrow aspirate from a patient with folic acid deficiency is shown. There is an erythroid hyperplasia with marked nuclear/cytoplasmic dysynchrony noted at all stages of erythroid maturation. Maturing erythroid precursor in the center of the slide shows nuclear budding.
Marked megaloblastic changes seen in all stages of erythroid maturation: nuclear-cytoplasmic dysynchrony, open nuclear chromatin, and nuclear budding. Overall there is a decreased M:E ratio (myeloid to erythroid) secondary to a marked erythroid hyperplasia.
At a higher magnification of previous image the open, sieve-like chromatin (salt and pepper) pattern in nucleus of megaloblastic cells is apparent. Howell-Jolly Bodies can be seen in orthochromatic nucleated red blood cells. Nuclear budding is seen on the orthochromatic cell.
Myeloid cells showing megaloblastic changes. Two giant bands are seen on the left of the field. One of these has features referred to as a “kissing band." In the right upper corner of the field a late erythroid form with nuclear budding is noted.
A megakaryocyte with markedly increased nuclear lobulation is shown.
Megaloblastic erythroid precursors with open chromatin pattern.
Proerythroblasts may be large with an attenuated chromatin pattern.