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The updated WHO classification system for myelodysplastic syndromes (MDS) includes some new entities, in particular "refractory cytopenias with unilineage dysplasia (RCUD)". The following review article presents a short overview regarding all subvariants of MDS but with special emphasis on the rare subtypes of MDS that can be exclusively recognized histomorphologically: (1) Hypoplastic MDS (MDS-hypo), (2) Fibrotic MDS (MDS-F) and MDS with associated systemic mastocytosis (SM-AHNMD).