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Bone marrow aspirate on second admission (Giemsa staining). A significant increase of monocytes (arrowhead) as well as plasma cells (arrow) was observed in bone marrow aspirates ((a), ×400 in magnification). Myelodysplastic change was also detected, showing as hypogranulated neutrocytes with Pseudo-Pelger nuclei ((b), ×1000 in magnification) or micromegakaryocytes ((c), ×1000 in magnification).
