Bone Marrow Pathology Evaluation

BMPE

Test Synonym:

CPT Code:
85097 – Bone marrow smear interpretation
85060 – Blood smear, peripheral, interpretation
88311 – Decalcification procedure
88305 – Surgical pathology
88313 xn – Special Stain
88342 xn – Immunohistochemistry

Turnaround Time:

Methodology:

Microscopic evaluation of bone marrow biopsy/clot prep (H&E) and peripheral/aspirate smears;
additional stains as required (iron, immunohistochemistry)

Specimen Requirements:

1cm Bone marrow core biopsy in 10% formalin or preferred B+ fixative(BBC  Biochemical)

Aspirate (clot) in formalin

Anticoagulated Aspirate: Heparin preferred for flow cytometry and cytogenetics; EDTA for molecular studies

4-6 air-dried marrow aspirate slides containing spicules

1 peripheral blood smear with CBC report

Causes for Rejection:

Improper specimen labeling; inadequate marrow for evaluation, improper sample submission, formalin leakage in transit can render slides uninterpretable

Specimen Stability:

Bone marrow core biopsy, aspirate clot, marrow or blood smears, stable indefinitely at 18-25°C

Marrow aspirate and EDTA blood - 48 hours at 18-25°C

Storage and Handling:

Ship samples ambient temperature

Reference Range:

Active cellular marrow; No cells diagnostic of malignancy

Indication:

A board certified hematopathologist / pathologist evaluates bone marrow morphology for malignancy, dysplasia, and non-neoplastic disease in context with provided clinical information and ancillary clinical findings. Unless otherwise requested, iron stains are routinely performed to assess iron storage and pathologic erythroid iron. Aspirate smears are reviewed and differential is reported. Submission of peripheral smears and CBC data are required for optimal interpretations. Results of flow cytometric, immunohistochemical, cytogenetic, or molecular analyses, when performed, are integrated in the final report.

References:

1. Foucar. (2001). Bone Marrow Pathology 2nd edition. ASCP Press