Collection and interpretation of bone marrow samples

image of Collection and interpretation of bone marrow samples
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The bone marrow is a complex and highly specialized organ within the central cavity of bone. It continuously produces large numbers of progeny cells that function to supply oxygen, defend against microbial agents, seal breaks in the vasculature and initiate wound healing. This chapter considers indications for bone marrow examination; collecting a bone marrow sample; interpretation of bone marrow samples.

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2.2 Bone marrow core biopsy needle (top) with stylet (middle) and disposable aspiration needle (bottom).
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2.3 Aspiration needle firmly seated in the wing of the ilium of a dog in sternal recumbency.
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2.4 Placement of bone marrow aspiration needle in humerus and sternum .
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2.5 Needle cap removed and stylet withdrawn.
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2.6 The syringe is attached, and several forceful aspirations yield thick sanguineous fluid.
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2.7 Thick drops of bone marrow are placed near the frosted edge of several glass slides.
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2.8 The slides are tilted to allow blood to run off on to absorbent tissue paper, leaving marrow particles attached to the glass.
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2.9 Slides are prepared by laying a glass slide at right angles across the remainder of the bone marrow drop, pulling the slides apart, and rapidly drying them in air.
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2.10 Placement of core biopsy needle in humerus of anaesthetized cat ; removal of sharp stylet and advancement of needle ; retrograde expulsion of the marrow core with the blunt stylet .
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2.11 Normal bone marrow core appears red and should measure at least 1.5 cm.
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2.13 Bone marrow smear with granulocytic hyperplasia comprised of segmented and band neutrophils, metamyelocytes, promyelocytes, myelocytes and extracellular iron (arrowhead).
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2.14 Bone marrow smear with erythroid maturation stages. Increasing nuclear condensation and acquisition of cytoplasmic haemoglobin indicates progressive maturity.
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2.15 Histological section of bone marrow from a cat with aplastic anaemia. There are only rare haemopoietic cells apparent among adipocytes.
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2.16 Histological section of bone marrow from a dog with advanced myelofibrosis. Normal haemopoietic tissue is replaced by fibrocytes and extracellular collagen and there is abundant focal iron deposition.
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2.17 Bone marrow smear with profound hypercellularity consisting of numerous undifferentiated large cells. The dog had acute leukaemia and pancytopenia on a haemogram.
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2.18 Higher magnification of Figure 2.17 . Most of the cells are blasts with a perinuclear clear area (Golgi zone). Two cells are in mitosis (arrowed) and normal haemopoietic cells are nearly absent.
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2.19 Bone marrow smear from a dog with acute leukaemia with granulocytic differentiation. The number of blast cells is increased, and differentiation to metamyelocytes and band neutrophils is apparent. There is a marked paucity of erythroid cells and megakaryocytes.
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2.20 Histological section of bone marrow from a dog with chronic lymphocytic leukaemia. The cells are packed densely in the bone marrow and there is an absence of megakaryocytes evident at low magnification.
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2.21 Bone marrow smear from a dog with multiple myeloma. There are malignant plasma cells, sometimes with two nuclei (arrows), and rare granulocytic or erythroid cells.
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2.22 Bone marrow smear showing two mast cells (arrows) among erythroid and granulocytic cells. The dog had multiple cutaneous mast cell tumours.
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