Conventional cytogenetics require a fresh specimen since live cells are induced to enter metaphase to allow chromosomes to be seen. Interphase fluorescence in situ hybridization testing, usually ordered together with conventional cytogenetic testing, offers rapid detection of several chromosome abnormalities associated with MDS, including del 5q, −7, +8, and del 20q. Virtual karyotyping can be done for MDS, which uses computational tools to construct the karyogram from disrupted DNA. Virtual karyotyping does not require cell culture and has a dramatically higher resolution than conventional cytogenetics, but cannot detect balanced translocations. Flow cytometry is helpful to identify blasts, abnormal myeloid maturation, and establish the presence of any lymphoproliferative disorder in the marrow. Testing for copper deficiency should not be overlooked, as it can morphologically resemble MDS in bone-marrow biopsies.The features generally used to define an MDS are blood cytopenias, ineffective hematopoiesis, dyserythropoiesis, dysgranulopoiesis, dysmegakaropoiesis, and increased myeloblasts. Dysplasia can affect all three lineages seen in the bone marrow. The best way to diagnose dysplasia is by morphology and special stains 
(PAS) used on the bone marrow aspirate and peripheral blood smear.
They propose that aged basal cells contain lipofuscin bodies that cannot be removed and might promote the aging of neighboring cells, generating a feedback loop that causes more and more neighbor cells to become aged and contain lipofuscins. Such cells might then aggregate into a spot with an irregular shape. They propose that the protrusion of a flat spot is a result of the death of aged cells in the spot and release of lipofuscin bodies. The aggregating cells would form a capsule, and the dense lipofuscin bodies make the protruding spot soft and dark in color. However, this proposal appeared as a preprint in 2015, has little direct empirical support, and has never been published in a peer reviewed journal. Another group has reported that "age spots" taken from human skin biopsies of patients facial senile lentigo of Fitzpatrick skin type III or IV aged 55–62 are enriched with senescent fibroblasts compared to surrounding skin. The dark coloration appeared to be due to higher melanin levels and activity of tyrosinase in the senescent fibroblasts than in the controls, potentially related to lower SDF1 expression. Patients were then administered six weekly treatments of microneedle fractional radiofrequency aimed at eliminating dermal senescent fibroblasts; this led to a marked decrease in epidermal pigmentation compared to baseline, accompanied by a decrease in the synthesis of collagen and the normalization of suppressed SDF1 expression. Treatment
Treatment for liver spots is almost never done for health-related reasons, though it is sometimes done for aesthetic ones.