How I Diagnose Low-grade Myelodysplastic Syndromes

Alexa J. Siddon, MD; Robert P. Hasserjian, MD


Am J Clin Pathol. 2020;154(1):5-14. 

In This Article

Interpretive Challenges

The most common challenges as well as errors encountered in the diagnosis of low-grade MDS center on (1) the certainty of whether sufficient morphologic dysplasia is actually present and (2) whether any dysplasia is being caused by MDS rather than a secondary cause (Table 2). The inherent subjectivity of dysplasia interpretation, even among very experienced hematopathologists, compounds the difficulties in the interpretation of bone marrows in patients with persistent cytopenias. Finally, our expanding knowledge of the molecular genetic findings in myeloid neoplasms can be difficult to integrate with the morphologic diagnosis. In the following section, some of the most common questions the authors have received about the diagnosis of low-grade MDS are discussed.