A 66-year-old woman comes to the office due to 2 months of worsening fatigue and dyspnea with moderate exertion. The patient has a history of breast cancer treated with surgery and combination chemotherapy 6 years ago. She has no other medical conditions. Vital signs are within normal limits. Physical examination reveals normal jugular venous pressure, clear lungs, and normal heart sounds; there is no hepatosplenomegaly, lymphadenopathy, or extremity edema. Laboratory results are as follows: Peripheral blood smear shows oval macrocytic red cells and hyposegmented neutrophils. Bone marrow biopsy of this patient is most likely to reveal which of the following?

Question

A 66-year-old woman comes to the office due to 2 months of worsening fatigue and dyspnea with moderate exertion.  The patient has a history of breast cancer treated with surgery and combination chemotherapy 6 years ago.  She has no other medical conditions.  Vital signs are within normal limits.  Physical examination reveals normal jugular venous pressure, clear lungs, and normal heart sounds; there is no hepatosplenomegaly, lymphadenopathy, or extremity edema.  Laboratory results are as follows:  Peripheral blood smear shows oval macrocytic red cells and hyposegmented neutrophils.  Bone marrow biopsy of this patient is most likely to reveal which of the following?

Quizplus · Accepted Answer

Eductional Objective: Myelodysplastic syndrome is a clonal hematologic neoplasm marked by 1or morecytopenias and cellular dysplasia (eg, oval macrocytic erythrocytes, hyposegmented granulocytes).  Bone marrow evaluation usually reveals a hypercellular marrow, a mild or moderate increase in myeloblasts (<20% of total cells), and dysplastic erythrocytes/granulocytes.

A 66-Year-Old Woman Comes to the Office Due to 2