A bone marrow Prussian blue stain shows blue granules inside of macrophages. What disorder can be ruled out by this result?
a. Iron overload
b. Iron deficiency
c. Chronic disease
d. Lead poisoning
ANS: B
Blue granules inside of macrophages when the Prussian blue stain is performed represent storage iron (in the form of hemosiderin). Iron deficiency can be ruled out if iron stores are present; it proves that iron is available for production of hemoglobin. All the other disorders listed have iron stores, sometimes increased; thus the finding of iron stores would support, not rule out, any of them as a possible diagnosis.
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