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Megakaryocytic morphology in Janus kinase 2 V617F positive myeloproliferative neoplasm

Shuchi Ghai1, Sharada Rai1

  • 1Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.

South Asian Journal of Cancer
|July 14, 2017
PubMed
Abstract

Insights

Megakaryocyte morphology aids in diagnosing myeloproliferative neoplasms (MPNs). Distinct features in essential thrombocythemia (ET), myelofibrosis (MF), and polycythemia vera (PV) help differentiate these JAK2 V617F-mutated conditions.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Myeloproliferative neoplasms (MPNs) are characterized by abnormal megakaryocyte morphology.
  • The Janus kinase 2 (JAK2) V617F mutation is common in MPNs, but its correlation with megakaryocyte morphology requires further investigation.

Purpose of the Study:

  • To evaluate megakaryocyte morphology in bone marrow aspirates and biopsies of patients with BCR-ABL negative MPNs harboring the JAK2 V617F mutation.
  • To correlate specific morphological features with different MPN subtypes: polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF).

Main Methods:

  • A retrospective and prospective hospital-based study conducted from January 2011 to April 2015.
  • Morphological assessment of megakaryocytes in 15 bone marrow aspirates and biopsies from patients with PV, ET, and MF, all positive for the JAK2 V617F mutation.
  • Statistical analysis using Chi-square and Fisher exact tests with SPSS version 13.0.

Main Results:

  • Essential thrombocythemia (ET) showed large megakaryocytes with staghorn nuclei and abundant cytoplasm.
  • Myelofibrosis (MF) exhibited dense megakaryocyte clustering, staghorn nuclei, sinusoidal dilatation, and intrasinusoidal hematopoiesis.
  • Polycythemia vera (PV) displayed loose to dense megakaryocyte clustering with predominantly cloud-like nuclei. Overlapping features were observed between MF and PV, and between ET and early MF.

Conclusions:

  • Megakaryocyte morphology is a valuable tool for accurately diagnosing subcategories of MPNs.
  • Distinct morphological patterns can assist in classifying MPN patients, including those with JAK2 V617F mutations.
  • This aids in the categorization of clinically suspicious cases, potentially including JAK2 V617F-negative patients.
Keywords:
Janus kinase 2 V617Fmegakaryocytemyeloproliferative neoplasm

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