ABSTRACT
Background: Idiopathic Myelofibrosis is a non-leukemic myeloproliferative disorder
characterized by generalized fibrosis of the bone marrow in association with
extramedullary haematopoiesis mainly in the spleen and liver. Prominent among its
laboratory features are the presence of tear drop red blood cells (dacryocytes) and
immature red blood and white cells (leukoerythroblasts) in the peripheral blood film.
Aim: The objectives of this paper are to present a case of Idiopathic Myelofibrosis without
the usual peripheral blood film picture and also to review the available literature.
MethodfResu1t: We present a 57-year old pastor with 8 months history of gum bleeding
and easy fatiquability. His peripheral blood film did not show classical features of
myelofibrosis. However, the histology of bone marrow biopsy revealed extensive fibrous
tissue deposition commensurate with myelofibrosis.
Conclusion: Absence of peripheral dacryocytes and leukoerythroblasts can occur in
myelofibrosis. In the absence of molecular studies in resource-poor countries like Nigeria,
Hand E and Reticulin stains of the bone marrow (Trephine) biopsy remain the gold
standard in the diagnosis of Idiopathic Myelofibrosis(IMF).