Clin path Bone Marrow

britt611's version from 2017-01-30 23:00

Section 1

Question Answer
what are 6 reasons to evaluate bone marrow?1. non-regenerative anemia, 2. persistent, unexplained neutropenia, 3. persistent thrombocytopenia, 4. unexplained pancytopenia, 5. monoclonal gammopathy, 6. suspicion of neoplasia
what is a reason to evaluate BM in horses?to evaluate any RBC regeneration
What are some non-indication for BM evaluation?leukocytosis and polycythemia, lymphopenia
What should you always submit with a bone marrow sample?CBC!
What are 3 bone marrow collection sites in dogs and cats1. iliac crest, 2. proximal femur, 3. proximal humerus
What are 3 bone marrow collection sites for horses, ruminants and camelids?1. proximal ribs, 2. sternabrae, 3. ileium
What tube do you use to collect BM samples?EDTA- flushed syringe into a EDTA tube
How should you prepare a smear of BM sample?1. make a blood spear or cross smear 2. put sample into clean petri dish and pick out spicules to make a smear
How do you submit a aspiration (cyology) of BM?submit in EDTA tube and smears, DO NOT expose to formalin fumes
How do you submit a biopsy (histo) of BM?same spot as aspiration, biospy needle, fix sample in formalin

Section 2

Question Answer
a biopsy is the best to asses what?cellularity and tissue architecture
What is a biopsy better for diagnosing? fibrosis, necrosis and inflitrative disease
What are the negatives of biopsy?can be more expesnsive, longer turn around time and can miss cellular detaiils
Aspiration/cytology is best to asses what?individual cells, cellular differentiation, and cytologic detils
what are the benefits of cytology over biospy?less expensive, rapid results
What is a negative to cytology?you get more sample bias
Should you try to always submit biopsy and cytology of Bm?YES!

Section 3

Question Answer
What are 3 things to look for when evaluating BM?1. ratio of cell:fat, 2. cellularity changes, 3. are all 3 cell lines present
What is the normal ratio of Cells:fat?1:1 for adults, higher cellularity for young animals
What sample is best for evaluating cellularity?biopsy sample
why is cytology not best for evaluating cellularity?may show marked cellularity changes
what 3 cell lines do you look for?1. megakaryocytes, 2. erythroid cells, 3. myeloid cells
what do megakaryoctes turn in to?giant polyploid cells that fragment to make plts
What are normal appearances of erythroid cell line in BM?dark blue (basophillic) cytoplasma, nucli condensed in more mature cells, metarubicyes lose nuclei and become retics
What are normal appearances of myeloid cell lines?light blue cytoplasma, as they mature nuclei start to indent then lobulated, differentiate into granuloctyes and monocytes

Section 4

Question Answer
What are 6 abnormalites to look/notice when evaluating Bone marrow evaluation1. look for big changes in over all cellularity, 2. cont/estimate M:E ratio, 3. look for infectious organisms, 4. look for neoplastic cells, 5. look at staining iron stores, erythrophagia, 6. look at lymphocytes and plasma cells
young vs elderly animals in cellularityyounger animals will have a higher cellularity compared to older animals
what are 2 ways to describe hypercellularity?1. hyperplasia, 2. myelophthisis
Hyperplasia vs. myelophthisishyperplasia is the increase of normal cells compared to myelophthisis is increase in abnormal cells
define myelophthisisreplacement of hematopoetic cells with abnormal tissues (neoplastic or fibrosis)
What is the normal M:E ratio?1:1
What is an example of an infectious organism?leishmania (usually effects the skin), histoplasma capsulatum (fungal)
What can indicate you are looking a neoplastic cells?large and immature: large nuclei and dark blue cytoplasma - open chromatin = actively dividing
What is erthrophagiaNurse cells, Macrophages phagocytosis a RBC. break then down and use their parts to help other cells (iron storage hemosiderin to make hemoglobin)
When you see iron stored (hemosiderin) what should you think ofIMHA
if there are increased lymphocytes and plasma cells, what should we consider?immune reaction
what should we consider if there is a marked increase in one cell type?hemic neoplasia
What should you consider if marrow is >90% plasma cells?multiple myeloma
When do we expect to see regeneration in peripheral blood if the BM has nearly all cells are erythroid (including mitotic cells)?3 days!

Section 5

Question Answer
do you submit a bone marrow for: a cat with chronic worsening non regenerative anemia?YES~
do you submit a bone marrow for: a dog with neutrophil count of 50,000NO
do you submit a bone marrow for: a horse with chronic anemia?YES
do you submit a bone marrow for: a cat with neutropenia, thrombocytopenia and non regenerative anemai?yes!
do you submit a bone marrow for: a cow with persistent lymphopenia?NO!
do you submit a bone marrow for: a dog that is acutely bleeding with plt count of 20,000?no!

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