background
Myelodysplastic syndromes (MDS) are a group of hematopoietic disorders characterized by ineffective hematopoiesis, manifested by cytopenias in one, two, or three lineages. CD34+ micromegakaryocytes and giant platelets are extremely rare in MDS patients but may lead to unnecessary treatment. Therefore, we report and follow up an MDS case with such unusual findings.
Case study
A 57-year-old male veteran with a history of MDS, alcoholic cirrhosis, and portal hypertension presented to the emergency department in 2020 for evaluation following a power outage, during which a peripheral blood sample and bone marrow biopsy were obtained. Flow cytometry analysis of his peripheral blood detected 8% CD34+ cells. This finding raises the possibility of acute leukemic transformation from MDS. Further studies revealed that these CD34+ cells are not blasts but represent dysplastic micromegakaryocytes and giant platelets. During the 4-year follow-up period, the patient was alive and complained only of fatigue lasting several weeks. His laboratory results showed pancytopenia and persistent iron deficiency anemia.
conclusion
The finding of CD34+ dysplastic giant platelets in our case is unusual. Such findings can lead to a misdiagnosis of acute leukemia. It is important for pathologists to integrate morphological and flow cytometric findings for an overall diagnosis. This helps prevent overdiagnosis of acute leukemia in MDS patients. Furthermore, studying the population and behavior of CD34+ dysplastic platelets in MDS may be valuable and improve our understanding of disease pathology.
sauce:
Reference magazines:
Yu, H. (2026). Myelodysplastic syndrome with CD34 + micromegakaryocytes and giant platelets in peripheral blood: a case report. Journal of Clinical Pathology. DOI: 10.14218/JCTP.2026.00012. https://www.xiahepublishing.com/2771-165X/JCTP-2026-00012
