What type of cells are seen on peripheral smear in myelodysplastic syndrome?

In myelodysplastic syndrome (MDS), one of the characteristic features observed on a peripheral blood smear is the presence of pseudopelger-Huet cells. These cells are abnormal neutrophils that exhibit a hypolobulated nucleus, typically presenting as bilobed or occasionally monolobed. The presence of pseudopelger-Huet cells is indicative of ineffective hematopoiesis, a hallmark of MDS, where the bone marrow produces dysplastic and dysfunctional blood cells.

MDS often leads to various cytopenias and abnormal morphologies in blood cells, particularly neutrophils. The dysplastic changes reflect the underlying genetic abnormalities and disturbed cell maturation pathways. Therefore, the presence of these atypical neutrophils helps in the diagnosis of myelodysplastic syndrome and indicates the pathological changes occurring in the bone marrow.

While other features, such as microcytic erythrocytes or hypersegmented neutrophils, may arise in other hematological conditions, they are not specific to MDS. Elevated reticulocytes typically indicate a response to peripheral blood loss or hemolysis rather than the ineffective hematopoiesis seen in myelodysplastic syndromes.