Bone Marrow Trephine Biopsy — 2025-12-31

• Date: 2025-12-31
• Clinical diagnosis: AML, status post Day 21 Azacitidine + Venetoclax
• Reported by: Dr. Lekshmon K S / Dr. Neetu S Dathan
• Macroscopy: Two bony cores 0.1-1.5 cm
• Microscopy: 15-16 intact marrow spaces; 25-30% cellularity (reduced from 60% in first biopsy); erythroid islands predominant; few plasma cell aggregates; occasional myeloid collection with shift; megakaryocytes present
• Special stains: Perls Grade 3 iron stores; PAS — no additional findings; Reticulin Grade 1 (improved from Grade 1-2)
• Diagnosis: Mildly hypocellular marrow with erythroid predominance. IHC (M1) recommended to exclude increase in blasts.
• Interpretation: Compared to first biopsy (2025-11-20), cellularity decreased from 60% to 25-30% and reticulin improved from Grade 1-2 to Grade 1, suggesting treatment response.