Now that we know the answer is MDS-biTP53 let's see how we got to the answer...
I'll start from the beginning.. what exactly is this image that I showed you?
It's a whole genome view of using @bionano 's #OGM of a BM aspirate.. giving U a bird's-eye view of the chromosomes 1/

https://twitter.com/sanamloghavi/status/1742309248850415998

How do we interpret this? Easy!
normal cells have 2 copies of somatic chromosomes (1-22) one X & one Y if male, and 2 X if female.. (with some normal exceptions: i.e. men tend to lose their Y as they age... we think it's normal🤷‍♀️ or at least a very common somatic mosaicism) 2/

Best way to recognize pathological/neoplastic immunophenotypic changes is having a good grip on immunophynotypic variations in reactive/regenerative conditions… summarizing #FlowICCS22 plenary session 3 here👇🏻 🧵1/ #hemepath Normal granulocytic maturation patterns…. Plots follow maturation from promyelocyte (*) to neutrophils #flowiccs22 #hemepath 2/

@AaronGoodman33 Typical cytomorphology is characterized by “blasts” with hand mirror (red arrow, cytoplasm to the side) or pearl necklace (green arrow, small cytoplasmic vacuoles around nucleus) appearance #bpdcn #hemepath #RareDisease #WHOHEME 1/ @AaronGoodman33 Skin and lymph node are most common extramedullary sites of involvement. Skin infiltrate is usually dermal with an appreciable “grenz zone” (uninvolved band b/w dermis and epidermis).. Lymph node typically has diffuse or paracortical involvement #hemepath #WHOHEME #BPDCN

One of the difficult aspects of #hemepath training is time management in a high-paced/demanding environment & the ability to multitask effectively while learning a difficult discipline. Every yr I offer our fellows helpful tips I’ve learned so far 🧵👇🏻More tips welcome,pls add 1/ Get rid of paper…
Don’t do anything twice
Take ownership of your cases… they are just as much yours as they are your faculty’s

Just another ordinary day at #hemepathMDA … 🤯
60-70 y/o woman
To all brave #hemepath aficionados how would you classify this case?
Poll and individual high quality images below. Pls comment if you’re feeling particularly brave today, let’s talk new #WHO 😎 What’s your dx?

The story of 1 day in the life of a #hematopathologist… I’m too exhausted to make a fancy educational thread but here are some amazing 🔬 pics for your viewing pleasure. I diagnosed all cases in one day 🤯 only at @MDAndersonNews Happy almost weekend people 🥂 #hemepath 🧵 1/n Myeloproliferative neoplasm w/ concurrent BCR::ABL1 and JAK2 V617F ..the megekaryocyte morphology is clue to something beyond CML #mpnsm #PathOutPic 2/

Happy to share our latest paper w/ @SibaElHussein as lead author, out today in @BMTjournal ⚡️Acquired WT1 mutations contribute to relapse of NPM1mut AML following allogeneic hematopoietic stem cell transplant  rdcu.be/cEuxv #hemepath #leukemia #hemepathMDA WT1 mutations are present in ~7% of de novo AML, are typically Lof mutation involving exons 7-9 of the gene. They frequently (~15%) co-occur w/ NPM1mut & have detrimental impact in this setting, shown by @AkEisfeld and colleagues in  bit.ly/3eWQtXw @LeukemiaJnl