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Agranulocytosis   
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This case of rapidly regenerating agranulocytosis was diagnosed as MDS by 30% of the the participants of the \\\"Instand\\\" quality control round Bone marrow is dominated by neutrophilic precursors Mature granulocytes are lacking. Few band forms are present.
This case of rapidly regenerating agranulocytosis was diagnosed as MDS by 30% of the the participants of the \\\"Instand\\\" quality control round  (Position 1)Bone marrow is dominated by neutrophilic precursors  (Position 2)Mature granulocytes are lacking. Few band forms are present. (Position 3)

Many participants made a diagnosis of MDS. However, there is no dysplastic sign. Granulation of the more mature cells is clearly visible.Left shift does not prove the neoplastic nature. The quantitative relation between many promyelocytes and very few blasts is compatible with regeneration. One further blast
Many participants made a diagnosis of MDS. However, there is no dysplastic sign. Granulation of the more mature cells is clearly visible. (Position 4)Left shift does not prove the neoplastic nature. The quantitative relation between many promyelocytes and very few blasts is compatible with regeneration.  (Position 5)One further blast (Position 6)

Of course, blasts are suggestive of neoplasia. However, in states of rapid regeneration like agranulocytosis and in case of regeneration after chemotherapy for e.g. AML, some blasts can be found. Many cases of agranulocytosis show involvement of the erythropoietic lineage demonstrated by the "dysplastic" irregularly shaped nucleiIt is dangerous to use "dysplastic" features of erythroblasts like this irregularly shaped nucleus to establish an MDS diagnosis.
Of course, blasts are suggestive of neoplasia. However, in states of rapid regeneration like agranulocytosis and in case of regeneration after chemotherapy for e.g. AML, some blasts can be found.  (Position 7)Many cases of agranulocytosis show involvement of the erythropoietic lineage demonstrated by the "dysplastic" irregularly shaped nuclei (Position 8)It is dangerous to use "dysplastic" features of erythroblasts like this irregularly shaped nucleus to establish an MDS diagnosis.   (Position 9)

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