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Trephine biopsy revealed normocellular bone marrow without fibrosis with normal differentiation of granulocytic and erythroid lineage. A marked increase in megakaryocytic density was present. Megakaryocytes presented with moderate pleomorphism, most cells showing nuclear hyposegmentation with normal nuclear to cytoplasmic ratio (a) and a few myeloproliferative hypersegmented and atypical forms. Moreover megakaryocytic lineage displayed focal aggregation (b).
