In marrow, iron is stored by the macrophages which dispense the iron to the surrounding colony of erythroblasts. Prussian blue stain is used to detect the iron. Because not all microcytic hypochromic anemias are due to iron deficiency, but rather may be associated with increased storage iron such as in thalassemias or anemia of chronic disease, serum iron studies, and occasionally a bone marrow biopsy are performed to evaluate storage iron before beginning treatment with iron. The first image shows slightly increased storage iron in a patient with anemia of chronic disease. The image with no blue staining material is from a patient with iron deficiency anemia. How would you tell the difference between these disorders based on serum iron studies?
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