Megaloblastic Anemia · Pathology

What is the expected bone marrow appearance in a patient with megaloblastic anemia?

  1. Hypocellular with fatty replacement
  2. Hypercellular with megaloblastic changes
  3. Fibrotic with 'teardrop' red cells
  4. Normal cellularity with ring sideroblasts
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Correct answer: Hypercellular with megaloblastic changes

The marrow is typically hypercellular as it tries to compensate for the anemia. However, the erythropoiesis is 'ineffective,' meaning many precursors die in the marrow (intramedullary hemolysis) before reaching the circulation.

Difficulty: Medium Question 12 of 20

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