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HIV-related immune thrombocytopenia

View larger version (98K): [in this window] [in a new window]   Figure 1. This patient is a 53-year-old HIV-positive male who presented to clinic with easy bruising. He was noted to have a platelet count of 28k/ul. A bone marrow aspirate/biopsy was performed. The aspirate revealed marked megakaryocytic hyperplasia but was otherwise unremarkable. A low-power view of the aspirate is shown.

View larger version (100K): [in this window] [in a new window]   Figure 2. The previous image is shown at higher magnification and illustrates megakaryocyte hyperplasia with clustering. Variable nuclear lobation is apparent without evidence of dysplasia. A platelet antibody assay was positive, consistent with a diagnosis of autoimmune thrombocytopenia.

View larger version (133K): [in this window] [in a new window]   Figure 3. The bone marrow biopsy was 50% cellular and showed normal myeloid and erythroid maturation sequences. Megakaryocytes were markedly increased in number and show clustering, as illustrated in the center of this image.

View larger version (159K): [in this window] [in a new window]   Figure 4. A higher magnification of the previous image is shown. In contrast to a normal marrow in which 2–3 megakaryocytes can be seen at this magnification, there is a marked increase in megakaryocyte number consistent with a marrow response to peripheral platelet destruction. Megakryocytes of variable size and nuclear lobation are readily evident.

View larger version (128K): [in this window] [in a new window]   Figure 5. This image is from another area on the biopsy section and shows the same megakaryocytic hyperplasia with clustering previously noted.

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections HIV/AIDS - lymphopenia Megakaryocytic hyperplasia/hypoplasia Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?