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Atlas of Bone Marrow pathology
Mojmir Moulis, Josef Feit et al.
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+ Bone Marrow Pathology
+ Bone Marrow Examination
+ Bone Marrow Examination
+ Histological evaluation of the trephine biopsy core
+ Normal bone marrow
+ Bone Marrow Cellularity
+ Hematopoiesis
+ Non-tumorous Lesions of Bone Marrow
+ Reactive Hematopoietic Changes
+ Erythroid hyperplasia
+ Myeloid Hyperplasia
+ Eosinophilia
+ Increased Number of Megakaryocytes
+ Bone Marrow Hypoplasia and Aplasia
+ Aplastic Anemia
+ Pure red cell aplasia
+ Agranulocytosis
+ Amegakaryocytic thrombocytopenia
+ Anemias
+ Posthemorrhagic anemias
+ Acute Posthemorrhagic Anemia
+ Chronic Posthemorrhagic Anemia
+ Megaloblastic Anemia
+ Sideropenic Anemia
+ Chronic Kidney Disease Anemia
+ Anemias of Chronic Disorders
+ Hemolytic Anemias
+ Other anemias
+ Stromal Reaction and Bone Marrow Inflammation
+ Reactive lymphocytosis, benign lymphocytic aggregates
+ Reactive Plasmacytosis
+ Granulomas
+ Hemophagocytic Syndrome
+ Storage Diseases (Thesaurismosis)
+ Gaucher's Disease
+ Niemann–Pick Disease
+ Bone marrow tumorus diseases
+ Myelodysplastic Syndrome (MDS)
+ Refractory Cytopenia with Unilineage Dysplasia (RCUD)
+ Refractory Anemia with Ringed Sideroblasts (RARS)
+ Refractory Cytopenia with Multilineage Dysplasia (RCMD)
+ Refractory Anemia with Excess Blats (RAEB)
+ MDS with Isolated 5q Deletion (5q-syndrome)
+ Myelodysplastic Syndrome Unclassified (MDS NOS)
+ Myeloproliferative neoplasms
+ Polycythemia Vera (PV)
+ Essential Thrombocythemia (ET)
+ Primary Myelofibrosis (PMF)
+ Chronic Myeloid Leukemia (CML)
+ Chronic Neutrophilic Leukemia (CNL)
+ Chronic Eosinophilic Leukemia (CEL)
+ Mastocytosis
+ MPN unclassifiable (MPN-U)
+ Myelodysplastic-myeloproliferative diseases (MDS/MPD)
+ Chronic Myelomonocytic Leukemia (CMML)
+ Atypical Chronic Myeloid Leukemia (aCML)
+ Juvenile Myelomonocytic Leukemia (JMML)
+ Myelodysplastic-Myeloproliferative Diseases Unclassifiable
+ Acute Myeloid Leukemia (AML)
+ Lymphoproliferative Disorders
+ Acute Lymphoblastic Leukemia (ALL)
+ Chronic Lymphocytic Leukemia (CLL)
+ Prolymphocytic Leukemia (PLL)
+ Hairy cell leukemia (HCL)
+ Plasma Cell Neoplasms
+ Plasma Cell (Multiple) Myeloma
+ Solitary Plasmocytoma
+ Monoclonal Gammapathy of Undetermined Significance (MGUS)
+ Other Lymphoproliferative Diseases
+ Histiocytoses
+ Histiocytosis X (Langerhans Cell Histiocytosis)
+ Letterer-Siwe Histiocytosis
+ Hand-Schüller-Christian Histiocytosis
+ Eosinophilic Granuloma
+ Histiocytic Sarcoma
+ Metastatic Infiltration of the Bone Marrow
+ Posttheraupetic a Posttransplant Hematopoietic Changes
+ Posttheraupetic Hematopoietic Changes
+ Restitution of Hematopoiesis
+ Persistent Alterations of Hematopoiesis.
+ Posttransplant Alterations of Hematopoiesis
+ Pathology of the Bone
+ Other Disorders
Bone Marrow Examination

Indications for a bone marrow examinaton:

  • Myelodysplastic syndrome
  • Myeloproliferative disorder
  • Lymphoproliferative disorder
  • Metastatic infiltration of the bone marrow
  • Bone Marrow hypoplasia, anemias
  • Miscallaneous

Bone Marrow Examination Methods:

  • Sternal puncture: cytologic evaluation of bone marrow aspirate
  • Trephine biopsy: histologic evaluation of a bone marrow core and cytologic evaluation of a bone marrow imprint.
  • The material obtained by both sternal puncture and trephine biopsy may also be evaluated using other methods: imunoflowcytometry, cytogenetics, molecular genetics

Trephine biopsy sample collection:

  • Sampling from the posterior superior iliac spine
  • Sampling from the calcaneus  — in very small children
  • The sampling is performed using a trephine needle. First, local anestesia is applied; then the needle itself enters the body through a small incision and is pushed into the bone using increasing pressure combined with slight rotary motion.

Reasons for performing a trephine biopsy: quantification of the infiltrate, monitoring of post-treatment changes and restaging (in case of a relapse).

Indications for performing a trephine biopsy in oncology: suspected metastatic cancer, staging, post-treatment monitoring.

Histological evaluation of the trephine biopsy core:

  • Fixation in Lowi solution or formol, decalcification, paraffin wax processing
  • standard staining using HE
  • special staining — PAS, Gömöry, Perls, Van Gieson etc.
  • immunohistochemistry
  • electron microscopy
  • molecular genetic evaluation