Merisa Klaharn1, Tawatchai Pongpruttipan1, Weerapat Owattanapanich2
and Sanya Sukpanichnant1
1Department of Pathology and 2Department of Medicine, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok 10700, Thailand
Correspondence: Sanya Sukpanichnant, MD
Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University
Bangkok 10700, Thailand
Tel: +662 419 6504
Fax: +662 411 4260
• Th is study was partly presented in the oral presentation by Dr. Merisa Klaharn at the 27th Annual
Academic Meeting of the Royal College of Pathologists of Th ailand on February 24, 2016
at Ambassador Hotel, Bangkok, Th ailand.
• Th is study was supported by Siriraj Research Fund, Grant Number (IO) R015831034,
Faculty of Medicine Siriraj Hospital, Mahidol University.
• Tawatchai Pongpruttipan, Weerapat Owattanapanich and Sanya Sukpanichnant are supported
by Chalermphrakiat Grant, Faculty of Medicine Siriraj Hospital, Mahidol University.
Received 29 March 2016 ; Accepted 5 May 2016
Background: Dyserythropoiesis-like post-mortem changes in erythroid precursors at autopsy can look similar
to certain kinds of pathologic processes. Objective: This study is to evaluate nuclear changes in erythroid
precursors in marrow aspirate smears and histologic sections at different intervals after taken out from the
body, simulating post-mortem changes. Materials and Methods: Marrow aspirate and clotted marrow samples
from patients were evaluated for the percentages of erythroid precursors with dyserythropoiesis-like nuclear
changes (DLNCs) at 0, 1, 2, 4, 8, 12 and 24 hours after delayed fi xation at room temperature. Signifi cant
DLNCs were determined at 10% cut-off. Results: Thirteen cases had suffi cient samples for evaluation. Signifi
cant DLNCs were initially observed at 8 hours in 4 cases (30.8%), at 12 hours in 1 case (7.7%) and at 24
hours in 8 cases (61.5%) after delayed fi xation. Conclusion: DLNCs occur in all cases after delayed fi xation;
the earliest signifi cant one at Hour 8. This phenomenon can interfere with the evaluation of erythroid changes
concerning any disease related to dyserythropoiesis when encountered with delayed fi xation or as equivalent
to post-mortem changes at autopsy.