Lec. 8 - Bone Marrow

Exam 2

What is the main thing that is evaluated when looking at a bone marrow smear?

Hematopoiesis

What two things are examined on a bone marrow sample? Which one is an MLS in charge of?

• Core biopsy

• Aspirate - MLS does this

What 3 things are usually being done/checked for on a bone marrow aspirate/core biopsy?

• Anemia

• Leukemia

• Bone marrow donation

Where is a bone marrow biopsy performed? Where does the MLS do the aspirate slide?

Biopsy performed in hospital or doctor’s office.

• MLS is present at the procedure to make the slide by the patients bedside as soon as the aspirate is retrieved. Staining can be done in hematology lab

Where is the aspirate/biopsy taken from?

Adults: iliac crest

Children: other places

What is the procedure for taking a biopsy?

Use kit (has all sterile & disposable materials) → skin is cleansed → local anesthetic → small incision made with scalpel → Biopsy needle inserted through skin into bone w/ rotating movement to drill into bone

How many mL of the syringe is attached in the bone marrow and what is being done with it?

• Aspirates bone marrow & slide is made

  • Rest of aspirate is mixed with EDTA

How is the marrow biopsy taken?

Needle advanced further → motion inserts marrow biopsy inside it → needle withdrawn with minimal force → marrow core is removed from needle with probe → core placed in jar w/ formalin

What is an aspirate slide stained with and how many nucleated cells are counted?

Stained: Wright

Counted: 300-500 cells

What do you need to determine when counting the bone marrow nucleated cells? What is the normal ratio and how is it calculated?

Myeloid:erythroid ratio (M:E)

• Ratio 2:1 or 4:1 → WBCs/nucleated RBCs

How would the cells in this bone marrow smear be described as? (Consider, are there cells?)

Hypocellular (Lots of fat cells, lack of precursor cells)

How would the cells in this bone marrow smear be described as? (Consider, are there cells?)

Hypercellular (Little fat cells MANY precursor cells)

What is included in a bone marrow examination report?

pb blood smear, bone marrow aspirate, BM core biopsy