Skin: Primary and Secondary Gross Lesions
Q: What is the term for a localized, fluid-filled blister on the skin that is less than 1 cm in diameter?
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Megaloblastic anemia is caused by impaired DNA synthesis, most commonly due to vitamin B12 or folate deficiency. This defect affects all rapidly dividing cells, including those in the bone marrow. The hallmark is asynchronous maturation: the cytoplasm of red cell precursors (erythroblasts) matures normally (accumulating hemoglobin), but the nucleus remains immature and large because DNA replication is delayed. This produces large, distinctive precursor cells called megaloblasts. In the white cell lineage, giant metamylocytes and hypersegmented neutrophils are seen. The bone marrow is typically hypercellular because the body tries to compensate for the anemia, but the production is ineffective—many of these abnormal precursors are destroyed within the marrow itself (ineffective erythropoiesis).
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