Dr Diane Frankel
email: diane.frankel@univ-amu.fr

Elise Kaspi

Charlotte Grosdidier

Maud Arpin

Regis Costello

Patrice Roll

Enigma portal: Peritoneal effusion in a patient with myeloproliferative neoplasm

Keywords: peritoneal effusion, myeloproliferative neoplasm, essential thrombocythemia, primary myelofibrosis

For this patient, ascites revealed 16% of myeloid precursors including blasts, associated with 8% of basophils, rare megakaryocytes and erythroblasts at different maturation stages. Ascites caused by peritoneal extramedullary hematopoiesis is a rare evolution of primary myelofibrosis [START_REF] Amarapurkar | Portal hypertension and ascites in extramedullary hematopoiesis[END_REF]. The presence of megakaryocytes in pleural or peritoneal effusion is rare and mostly associated with myelofibrosis (3). Among 4,844 pleural or peritoneal effusions, Kumar et al. report megakaryocytes in 5 samples. In the case presented in this article, the clinical context helps to establish the diagnosis. Without any context and based on the cytological examination, the presence of hematopoietic precursors from 3 different lineages (myeloid precursors with blasts, megakaryocytes and erythroblasts) is indicative of a haematopoietic pathology. Leukemic transformation could be suggested by an increased percentage of blasts and a bone marrow biopsy or aspiration should be done to confirm the diagnosis [START_REF] Kaur | Cytomorphology, Immunophenotype, and cytogenetic profile of leukemic serous effusions[END_REF]. In this case the low percentage of blasts (3%) was more suggestive of myelofibrosis of myelofibrosis rather than a leukemic transformation.

The present report, in addition to documenting a rare case, highlights the pivotal role of peritoneal cytological examination in the diagnosis of such a case. Specialist haematopathology review is recommended in such cases to confirm the diagnosis..

Figures 1 , 2 and 3 .

 13 Figures 1, 2 and 3. Cytology of peritoneal effusion: May-Grünwald-Giemsa stain, x40. Representative images of the peritoneal effusion. Scale bar: 20μm.

Figure 4 .

 4 Figure 4.

Figure 4

 4 Figure 4 corresponds to figure 1 with cell annotations. Meso: mesothelial cell; ortho: orthochromatophilic erythroblast; baso: basophils; myel: myeloid precursors; blast: blast cells. Scale bar: 20μm.

Figure 4

 4 Figure 4 corresponds to Figure 1 with annotations. Extramedullary hematopoiesis is a consequence of sequestration and proliferation of circulating clonal myeloid precursors to atypical sites. It can occur in any organ, but the most frequent ectopic sites are spleen and liver (1).

Summary

Quiz related to cytological analysis of peritoneal effusion in a patient with history of myeloproliferative neoplasm.

Case history

A 81-year-old male presented an essential thrombocythemia with JAK2 p.V617F mutation in 2016. He was treated with hydroxyurea until February 2022 when a tricytopenia was observed. Histological findings of bone marrow biopsy revealed a primary myelofibrosis with diffuse fibrosis and without blasts. In May 2022, he was admitted to the emergency and an echography detected a splenomegaly (spleen measuring 16 cm) associated with pleural and peritoneal effusions. The peritoneal effusion was aspirated (see images in figures).

Question 1

Based on Figure 1

Data availability statement

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Two liner

This case describes an extramedullary hematopoiesis in ascites from a patient diagnosed with myelofibrosis


M Boudault

Léa Vignaud

S Cordonnier

Bruno Frédérich

Charlotte R Dromard

D Lecchini

Morpho- Logical

Morphological variability of Ocyurus chrysurus in coral reefs of Guadeloupe (Lesser Antilles)

établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Material and method

Results and discussion

-The deformation grids allow to visualize the ontogenic trajectories taken by the body of Ocyurus chrysurus, during its growth: the insertion of the fins on the body changes and the body profiles hydrodynamically. Contrary to the global trend observed in reef fishes, in Ocyurus chrysurus, the body shape is significantly more different between the juvenile and adult stages than between the post-larval and juvenile stages.

-The juvenile life stage of this species is characterized by association with seagrass beds, similar to other representatives of the Lutjanidae, found in the western Atlantic (Garcia et al., 2003;Radford et al., 2011). As adults, yellowtail snappers definitely move closer to the reefs and become a large predator, feeding on shrimp, crabs, but also fish (Bortone and Williams, 1986). This radical variation in the diet of the species certainly requires great changes in its morphology, especially between the juvenile and adult stages as observed in this study.

Morphological variability of Ocyurus chrysurus in coral reefs of Guadeloupe (Lesser Antilles)

Introduction -The morphology of reef fish is mostly related to the way the species feeds.

-The tool used to quantify morphological variations during ontogeny : allometry by geometric morphometry (Bookstein, 1992).

Ocyurus chrysurus in the post-larval (A), juvenile (B) and adult (C) stages with landmarks on interest points.

-The objective of this study is to start a morphometric analysis project on reef fish species from Guadeloupe, and more particularly on the differences in shape observable between the ontogenetic post-larval, juvenile and adult stages of Ocyurus chrysurus.

-Images were processed using the "TPS" suite of geometric morphometry software.

-Several types of traps were used: the ridge net, the "CARE" trap (Collected by Artificial Reef Ecofriendly), the senne net and dip nets. Adult individuals were recovered from fishermen.

Deformation grids with the average shape of post-larvae (D) and adults (E) of Ocyurus chrysurus, with the landmarks distributed previously.

-A principal component analysis was applied on the shape variables, which allowed the realization of the deformation grids. The significance of shape differences between ontogenetic stages was tested using F-tests (TwoGroup8 software). This test also reports a Procrustean distance value, a value directly proportional to the existing shape difference between the average shape of two groups corresponding to stages.

Procrustes distances separating each group.

Material and method

Individuals were sampled in the Petit and Grand Cul de Sac Marin of Guadeloupe. Several types of traps were used: the ridge net, the "CARE" trap (Collected by Artificial Reef Ecofriendly), the senne net and dip nets. Adult individuals were recovered from fishermen. Individuals were euthanized with eugenol diluted in seawater following the sampling, then photographed in lateral view, the body fixed and the fins extended with entomologist's pins. Images were processed using the "TPS" suite of geometric morphometry software. A principal component analysis was applied on the shape variables, which allowed the realization of the deformation grids. The significance of shape differences between ontogenetic stages was tested using F-tests (TwoGroup8 software). This test also reports a Procrustean distance value, a value directly proportional to the existing shape difference between the average shape of two groups corresponding to stages.

Results and discussion

The deformation grids allow to visualize the ontogenic trajectories taken by the body of Ocyurus chrysurus, during its growth: the insertion of the fins on the body changes and the body profiles hydrodynamically. Contrary to the global trend observed in reef fishes, in Ocyurus chrysurus, the body shape is significantly more different between the juvenile and adult stages than between the post-larval and juvenile stages.

The juvenile life stage of this species is characterized by association with seagrass beds, similar to other representatives of the Lutjanidae, found in the western Atlantic (Garcia et al., 2003;Radford et al., 2011). As adults, yellowtail snappers definitely move closer to the reefs and become a large predator, feeding on shrimp, crabs, but also fish (Bortone and Williams, 1986). This radical variation in the diet of the species certainly requires great changes in its morphology, especially between the juvenile and adult stages as observed in this study.

Morphological variability of

Introduction :

The morphology of reef fish is mostly related to the way the species feeds. It influences swimming ability and foraging. The tool used to quantify these morphological variations during ontogeny is called allometry by geometric morphometry (Bookstein, 1992). This quantification allows first of all the identification of even slight morphological differences or similarities between individuals, and then to understand the ecology of the species when these laboratory observations are combined with naturalistic observations, which is then called ecomorphology. Studies of this kind have been carried out in large numbers on herbivorous and omnivorous fish species in the Pacific region, but few have been carried out in the Caribbean region and even fewer on carnivorous species in the Lesser Antilles. The objective of this study is to start a morphometric analysis project on reef fish species from Guadeloupe, and more particularly on the differences in shape observable between the ontogenetic post-larval, juvenile and adult stages of Ocyurus chrysurus.

Ocyurus chrysurus in coral reefs of Guadeloupe (Lesser Antilles)

  MEHDI BOUDAULT ,2 , LÉA VIGNAUD ,2 , SÉBASTIEN CORDONNIER, BRUNO FRÉDÉRICH, CHARLOTTE R.DROMARD 1,2 , DAVID LECCHINI 4