What finding would you expect on a bone marrow biopsy in sideroblastic anemia?

In sideroblastic anemia, the bone marrow biopsy typically reveals the presence of ringed sideroblasts. These sideroblasts are erythroblasts that have abnormal iron deposition in the mitochondria, giving them the characteristic ringed appearance when stained and viewed under a microscope. This is a fundamental finding in sideroblastic anemia, which can be caused by various factors, including genetic mutations, certain toxins, and deficiencies of vitamin B6.

In this condition, the body's ability to properly incorporate iron into hemoglobin is impaired, leading to ineffective erythropoiesis and the accumulation of iron in the mitochondria. The presence of ringed sideroblasts serves as a key diagnostic feature in identifying sideroblastic anemia, distinguishing it from other anemias.

The other potential findings in the choices provided do not align with the typical presentation in sideroblastic anemia. For example, nuclear fragmentation and myeloblasts are more consistent with distinct types of hematological malignancies or conditions such as acute leukemia, while hypocellularity generally indicates decreased bone marrow activity, which is not a hallmark of sideroblastic anemia, where hypercellularity with ineffective erythropoiesis is often observed. Thus, the identification of ringed sideroblasts is