A 65-year-old man has a 7-month history of fatigue and abdominal discomfort. Examination shows splenomegaly and hepatomegaly. A complete blood count shows anemia, teardrop erythrocytes, and a leukoerythroblastic reaction. A bone marrow biopsy shows myelofibrosis. Which of the following findings is most likely to be seen on microscopic examination of tissue from the spleen? A) Decrease of both red and white pulp B) Enlargement of the white pulp C) Erythrophagocytosis in the splenic cords D) Prominent collections of lipid-filled macrophages E) Trilineage hematopoiesis
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The bone marrow fibrosis is due to proliferation of abnormal megakaryocytes that release platelet-derived growth factor and transforming growth factor-β, leading to increased deposition of reticulin and collagen fibers by marrow fibroblasts. As the bone marrow Show more…
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