Microscopic evaluation of bone marrow biopsy / clot prep (H&E) and peripheral / aspirate smears;
additional stains as required (iron, immunohistochemistry)
1.0 cm bone marrow core biopsy in formalin or B Plus fixative
Aspirate (clot) in formalin
Aspirate in sodium 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
Ship samples ambient temperature.
Improper specimen labeling; Inadequate marrow for evaluation; Improper sample submission; Formalin leakage in transit can render slides uninterpretable
Active cellular marrow; No cells diagnostic of malignancy
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.
Foucar.(2001). Bone Marrow Pathology 2nd edition. ASCP Press.