Same sample of bone marrow, received different opinion

[Vigiindia]

Hi all

As early i had said that i have all test negative and bone marrow was normocellular... I just checked bone marrow block with another hematologist and he said hypercellular

I am just confused who is wrong and who is right?

And am frustrating to know is that secondary Polycythemia or polycythemia vera!!??

Please suggest guys what to do?

[Wyebird]

Oh dear I can’t offer any advice. What a conundrum. Maybe Maz can help. It’s my undrstanding she has links with MPN gurus.

[clubdino]

My hematologist once said that he never really paid attention to whether or not a sample was hypercellular, hypocellular, or normocellular because it all depended on where the sample came from in the bone. He said one part of the bone could be hypercellular and another part could be hypocellular. So I'm not sure I would concentrate on that part too much. Was there anything in the new report that indicated that you have a MPN except for the fact that it stated hypercellular?

[Vigiindia in reply to clubdino]

Thanks clubdino

Yes in the impression, hypercelluler marrow with reactive mild increase of erthroid cell,and myleoid cell is normal

[clubdino in reply to Vigiindia]

Im sorry, but it sounds like you're not going to get a definite diagnosis from your bone marrow biopsy. I had a BMB that was also inconclusive over a decade ago so I went undiagnosed for many years. I was only diagnosed years after they discovered the CALR mutation. I am assuming your blood has been tested for the three genetic mutations?

[clubdino in reply to Vigiindia]

Actually, I just read your previous post. Sound like you probably have secondary polycythemia. Yes, it can go away if you quit smoking. Anything that causes a loss of oxygen in the body (smoking) can cause secondary polycythemia.

[Vigiindia in reply to clubdino]

Thanks clubdino for ur valuable suggestions

It seems like undiagnosed secondary polycythemia.

Bcs EPO also normal my spleen also normal.

I had tested for Jack2v617f and jack2exon12-K539L mutations and both are negative..CALR not offer by hematologist bcs my WBC and platlates is in normal range.

[clubdino in reply to Vigiindia]

I think the fact that your other two cell lines are in normal range and you have a normal spleen size are two more positive signs that this is only secondary polycythemia. Of course, you need to keep an eye on it to be sure. Good luck to you.