Detection of megakaryocytes cytoplasm fragments in peripheral blood by microscopy
https://doi.org/10.35754/0234-5730-2026-71-2-251-257
Abstract
Introduction. Megakaryocytes, in addition to their function of producing platelets and maintaining their quantitative composition in the bloodstream, are a strong immune trigger. The release of these cells from the bone marrow into the peripheral blood occurs under certain conditions, both physiological and pathological.
Aim: to present a case of detecting fragments of megakaryocyte cytoplasm in an elderly patient with ischemic stroke during microscopy of a peripheral blood smear.
Main findings. When conducting a clinical blood test on an elderly patient with an ischemic stroke, a hematological analyzer revealed significant thrombocytopenia, which had not been previously observed. The number of platelets was determined using the optical method, but the platelet aggregation flag remained (100 %). Morphological examination of blood under a microscope revealed fragments of megakaryocyte cytoplasm arranged in clusters in the brush preparations, and the number of platelets corresponded to the analysis data. Upon repeated blood sampling, the number of platelets remained normal. Microscopic examination of the blood revealed platelets in the form of clusters and individual forms. Thus, when platelets are consumed excessively in certain pathologies, fragments of megakaryocytes are released into the circulation, where they “mature”. Within a few hours, the demarcation membrane formed in megakaryocytes divides the cytoplasm into numerous mature platelet plates. In order to predict the progression of thrombocytopenia and exclude early heparin-induced thrombocytopenia, it is necessary to select blood samples for clinical analysis based on specific criteria.
About the Authors
M. V. Prokopyeva
Leningrad Regional Clinical Hospital
Russian Federation
Russian Federation
Marina V. Prokopyeva, Clinical Laboratory Diagnostics Specialist at the Clinical and Diagnostic Laboratory
194291, Saint Petersburg
S. A. Nefedova
Leningrad Regional Clinical Hospital
Russian Federation
Russian Federation
Svetlana A. Nefedova, Biologist of the Clinical and Diagnostic Laboratory
194291, Saint Petersburg
Z. S. Vagabov
Leningrad Regional Clinical Hospital
Russian Federation
Russian Federation
Zalimkhan S. Vagabov, neurologist of the Intensive Care unit of the Neurological Department
194291, Saint Petersburg
L. A. Kornoukhova
Leningrad Regional Clinical Hospital; Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Lubov A. Kornoukhova, Cand. Sci. (Med.), Head of the Clinical and Diagnostic Laboratory; Associate Professor of the Department of Clinical Laboratory Diagnostics with a course in Molecular Medicine
194291, Saint Petersburg
197022, Saint Petersburg
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Review
For citations:
Prokopyeva M.V., Nefedova S.A., Vagabov Z.S., Kornoukhova L.A. Detection of megakaryocytes cytoplasm fragments in peripheral blood by microscopy. Russian journal of hematology and transfusiology. 2026;71(2):251-257. (In Russ.) https://doi.org/10.35754/0234-5730-2026-71-2-251-257
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