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Commentary 8.

The picture shows a giant metamyelocyte (compare the size with the neutrophil at the top right hand corner) and two well-spread early megaloblasts. The megaloblastic anaemia was attributed to folate deficiency. The earliest erythroid precursors recogniseable in bone marrow smears, whether normal proerythroblasts or megaloblasts, have deeply basophilic cytoplasm reflecting their high content of the RNA needed for the synthesis of haemoglobin, and other red cell proteins. The deeply basophilic cytoplasm forming a ring around the somewhat paler active nuclear chromatin gives such cells their distinctive appearance. Giant metamyelocytes are "end cells" which do not develop further.

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