Which diagnosis is suggested by tear-drop (dacrocytes) RBCs and a dry tap with bone marrow fibrosis and a positive JAK2 mutation?

Get ready for the CAMLPR Hematology Test. Use our quizzes, flashcards, and detailed explanations to enhance your understanding. Prepare confidently for your exam!

Multiple Choice

Which diagnosis is suggested by tear-drop (dacrocytes) RBCs and a dry tap with bone marrow fibrosis and a positive JAK2 mutation?

Tear-drop red cells, a dry tap on bone marrow aspiration, marrow fibrosis, and a positive JAK2 mutation all point to primary myelofibrosis. Tear-drop cells arise because the fibrotic marrow distorts developing red cells as blood formation shifts to alternate sites (extramedullary hematopoiesis). The fibrotic marrow makes it hard to aspirate, producing a dry tap. The JAK2 V617F mutation is common in myeloproliferative neoplasms, and its presence strongly supports a myeloproliferative process like primary myelofibrosis rather than an acute leukemia or lymphoid leukemia. Hairy cell leukemia can involve the marrow and cause cytopenias and sometimes a dry tap, but it typically shows hairy cells and a different mutation profile (not predominantly JAK2). Acute myeloid leukemia would present with blasts in blood/marrow rather than a fibrotic dry tap pattern. Chronic myeloid leukemia centers on BCR-ABL and lacks the characteristic tear-drop RBCs with marrow fibrosis and JAK2-driven pathology.

Tear-drop red cells, a dry tap on bone marrow aspiration, marrow fibrosis, and a positive JAK2 mutation all point to primary myelofibrosis. Tear-drop cells arise because the fibrotic marrow distorts developing red cells as blood formation shifts to alternate sites (extramedullary hematopoiesis). The fibrotic marrow makes it hard to aspirate, producing a dry tap. The JAK2 V617F mutation is common in myeloproliferative neoplasms, and its presence strongly supports a myeloproliferative process like primary myelofibrosis rather than an acute leukemia or lymphoid leukemia.

Hairy cell leukemia can involve the marrow and cause cytopenias and sometimes a dry tap, but it typically shows hairy cells and a different mutation profile (not predominantly JAK2). Acute myeloid leukemia would present with blasts in blood/marrow rather than a fibrotic dry tap pattern. Chronic myeloid leukemia centers on BCR-ABL and lacks the characteristic tear-drop RBCs with marrow fibrosis and JAK2-driven pathology.

More practice questions