Fig. 1. Bone marrow (BM) histopathologic and cytogenetic findings at diagnosis. (A, B) BM aspirate and biopsy showed left-shifted granulocytic hyperplasia with a high myeloid:erythroid ratio and megakaryocytes with small hypolobated (dwarf) forms (A: Wright-Giemsa stain, ×1,000, B: hematoxylin and eosin stain, ×400). (C) The composite pictures from the aspirate smears showed small single or multiple ring-form organisms within the erythrocytes. One of the erythrocytes in the left lower part showed the stage occurring after the breakdown of the classic tetrad (“Maltese cross”) (Wright-Giemsa stain, ×1,000). (D) Fluorescent in-situ hybridization in BM specimen using tri-color dual fusion probes (BCR/ABL1/ASS1) demonstrated BCR/ABL1 translocation (red-green fusion) in 3 interphase cells. ABL1 and ASS1 probes in chromosome 9q34 region and BCR probe in chromosome 22q11.2 region showed red, aqua, and green signals, respectively (Abbott Molecular, Abbott Park, IL).

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