Technical Preparation of Bone Marrow Specimens for Histological Assessment

(based on 43 customer ratings)

Brooke Eguia, MS, BS, HT(ASCP), HTL(ASCP)
Reviewer: Donna M. Hedger, BS, HT(ASCP)

This course provides information about the clinical indications for bone marrow examination and detailed instruction for the preparation of bone marrow smears used for histological testing.

Continuing Education Credits

Objectives

  • Recognize the indications for bone marrow examination.
  • Describe optimal technical preparation techniques for blood smears, bone marrow aspirates, and bone trephine biopsies.
  • Discern common bone marrow preparation components.
  • List specialized techniques used for bone marrow evaluation.

Course Outline

  • Clinical Indications
      • Bone Marrow Examination: Clinical Indications
  • Bone Marrow Procurement
      • Bone Marrow Procurement
      • Bone Marrow Procurement: Supplies
      • Bone Marrow Procurement: Aspirate
      • Bone Marrow Procurement: Core Biopsy
      • Aspirate: Optional Immediate Bedside Smear Preparation
      • Core Biopsy: Optional Immediate Bedside Imprint Preparation
      • In adult patient populations, what is the preferred site for the collection of bone marrow aspirates and biopsies?
      • The core biopsy should be red, with grossly identifiable bone particles.
  • Bone Marrow Core Imprints
      • Bone Marrow Core Imprints (Touch Preparation)
  • Bone Marrow Aspirate Preparation: Anticoagulated Sample
      • Anticoagulated Aspirate Sample: Bone Marrow Layers
      • Occasionally, the percentages of the bone marrow "crit" are difficult to discern and re-centrifugation might help.
  • Bone Marrow Aspiration: Laboratory Technical Preparation
      • Myeloid-Erythroid (M-E) cells/Concentrate/Buffy Coat Smears
      • To prepare the myeloid-erythroid (ME)/concentrate/buffy coat smears, a clean pipette should be used to make the concentrate. After pipetting off the e...
  • Bone Marrow Clot Preparation
      • Bone Marrow Clot Preparation
      • The clot section includes the remaining particles from the aspirate and red blood cells. Three levels, usually sectioned at 3 microns thick, are stain...
  • Bone Marrow Core Biopsy
      • Bone Marrow Core Biopsy
      • Bone marrow core biopsy specimens do NOT allow for the best evaluation of bone marrow cellularity, cellular distribution, and cellular relationships a...
  • Iron Stain on Spun Bone Marrow Aspirate Fat-Perivascular Layer
      • Iron Stain on Spun Bone Marrow Aspirate Fat-Perivascular (F-PV) Layer
      • In order to not disrupt fat cells, alcohol fixation of the fat-perivascular (F-PV) slide used for iron store evaluation with the Prussian blue iron st...
  • Iron Stain on Bone Marrow Concentrate (Myeloid Erythroid Layer)
      • Technical Preparation of Iron Stain on Bone Marrow Concentrate (Myeloid-Erythroid Layer)
  • Immunohistochemical (IHC) Stains
      • Metastatic Carcinoma Immunohistochemical (IHC) Stains
      • CD138 Immunohistochemical (IHC) Stain
      • CD34 Immunohistochemical (IHC) Stain
      • CD117 or Mast Cell Tryptase Immunohistochemical (IHC) Stains
  • Special Stains
      • Reticulin Stain
      • Prussian Blue Iron Stain
      • Bacterial and Fungal Stains
      • Amyloid Stain
      • Amyloid deposits are most commonly identified on core biopsy specimens, but may also be seen on aspirate smears.
      • Which stain is commonly utilized to detect iron in bone marrow specimens?
  • Histochemical Stains
      • Enzyme Stains
      • The application of enzyme/histochemical stains by the pathologist will NOT change the classification of the disease in a bone marrow biopsy specimen s...
  • Esoteric Testing
      • Esoteric Testing
  • References
      • References

Additional Information

Level of instruction: Basic to intermediate
 
Intended audience: Clinical laboratory histotechnologists, histotechnicians, and other medical laboratory personnel who have an interest in this subject matter. This course is also appropriate for histology and clinical laboratory science students, pathology residents, and practicing pathologists.
 
Author information: Brooke Eguia, MS, BS, HT(ASCP), HTL(ASCP) is the Pathology Technical Supervisor at Fairview Southdale Hospital in Edina, Minnesota. She graduated from St. Cloud State University with a Bachelor of Science degree in general biology and from Capella University with a Master of Science in Human Service with a specialization in Health Care Administration. During her time as an undergraduate, Brooke's interests and studies focused on histologic techniques and gross anatomic dissection. Acting as a primary health career mentor to high school students, Brooke satisfied her desire for training and teaching histotechnicians and also worked as adjunct faculty at Rasmussen College, as a Medical Assistant laboratory techniques instructor. Most recently, she has focused on proctoring histology students in clinical/classroom progress and exam preparation.
 
Reviewer information: Donna M. Hedger, BS HT(ASCP), is currently a sales specialist at MediaLab. After graduating from Georgia Southern University with a Bachelor of Science in Biology, she spent 25 years working in the operations of the healthcare laboratory at Northside Gwinnett (formerly Gwinnett Medical Center). During her tenure there, she worked in various roles, including phlebotomy, lab assistant, pathology assistant, histology technician and more recently as the manager of the Pathology Laboratory for 18 years. She is a certified histology technician.
 
Course description: This course provides information about the clinical indications for bone marrow examination and detailed instruction for the preparation of bone marrow smears used for histological testing. 

This course is part of:
Bone Marrow 1
Particle crush
Bone Marrow 8
bone marrow
Bone Marrow 18
Bone Marrow 20
Bone marrow biopsy demonstrating a lack of iron stores
AD09-173 Bone Marrow Toxoplasma g.
Case of disseminated Toxoplasmosis infection in bone marrow from a heart transplant patient demonstrated with Toxoplasma gondii mouse monoclonal antibody, clone TP3. DAB chromogen.