ABSTRACT
Myelodysplastic syndrome (MDS) is a group of heterogeneous clonal hematopoietic stem cell disorders characterized clinically and morphologically by ineffective hematopoiesis and dyspoiesis leading to cytopenia(s) and risk of progression to acute leukemia. The diagnosis of MDS is suspected based on the presence of unexplained cytopenia(s). Blood, apart from anemia, which is the most common finding in MDS, may show neutropenia and/or thrombocytopenia. MDS with fibrosis needs to be differentiated from acute panmyelosis with fibrosis and other bone marrow (BM) processes with significant reticulin fibrosis, both primary and secondary. The BM is hypocellular with dyserythropoiesis and no increase in blasts. The immunohistochemistry staining of the BM in patients with MDS provides additional information, which may be very helpful in the diagnosis of MDS and to exclude other neoplasms that may be associated with cytopenia(s). Patients with idiopathic cytopenia of undetermined significance should be carefully monitored with repeated tests to exclude progression to MDS.
