Megakaryocytic Alterations in Thrombocytopenia: A Bone Marrow Aspiration Study

Background: Thrombocytopenia is defined as platelet count less than 150,000 /mm3 (150x109 /litre) and is commonly seen in various haematological disorders and nonhematological conditions and may be associated with dysplastic megakaryocytes which is a feature of myelodysplastic syndrome. Objective: To study the morphological variations of megakaryocytes on bone marrow aspiration smears in Non MDS related thrombocytopenia in MGM Medical College and MY Hospital Indore. Materials and Methods: Retrospective study of 76cases of non MDS thrombocytopenic patients. Patients presenting with platelet count <150,000/mm3 from June 2019 to July 2020 at MGM medical college, Indore were included in the study. Results: The most common cause of thrombocytopenia was megaloblastic anaemia followed by acute leukaemia, chronic leukaemia idiopathic thrombocytopenic purpura. Both dysplastic and nondysplastic features were observed in the above mentioned conditions. The most common dysplastic feature was nuclear segmentation followed by micromegakaryocytes and hypogranular forms. The common nondysplastic features observed were immature forms (most common) bare nuclei, and hypolobation. Conclusion: Dysplastic megakaryocytes are common in non-MDS-related thrombocytopenia and their mere presence should not lead to the diagnosis of MDS. Hence, proper diagnosis should be made on megakaryocyte morphology. Patient’s clinical findings and other haematological parameters. This understanding can improve the diagnostic accuracy for wide range of haematological disorder