Bone Marrow Flashcards
Toon need in bm aspiration
Jemshidi trephine and salah aspuration needle
Bone marrow in acute keukemia
Necessary for diagnosis
Usefuk for determining type
Useful for prognosis
Acute leukemia are defined by the presence of
Dec 20% blast in BM % of nucleated cells
Bm aspirate and trephine
Hypercellular
Blast dec 20%
Presemce of auer rods which AML type
Stains are to differentiate
AML And ALL
What stains posituve in AML
Sudan black and myeloperoxidase
Wbc cyt in aml can be
High, normal or low
Median wbc count in amo
15,000 ul
20000 of patients have
More than100,000ul
25-40% of pts in aml have
Less than 5000 ul
95% patients in aml have
Blast cells in blood smear
Distinguishing aml from allf
Light microscopy
Flow cytometry
Special stains
In light microscopy AML has
Auer rods, cytoplasmic granules
In light microscopy ALL has
No auer rods and granules
This has been useful tool in differentiating hematopoietic dse
Cytochemical staining of cells
Smears and imprints made from wht preferred
Bm, lymph node, spleen, peripheral blood
In enzaymatic technique this is used for ensure optimal enzyme activity
Fresh smear
Reacts with peroxide and release oxygen which oxidizes tte indicator dye and produce what color of granules
Speroxidase enzyme orange brown
Indicator dye of mpo
3 amino 9 erythrocarbazol
Enzyme mpx is found in the 1st granules of
Granulocyte, neutro, promyelocyte and eosino
In mox this may be weakly pos
Monocyte
Usualky positive and auer rods stain very strong
Leukemic myeloblast
Used to diff aml + and all -
Myeloperoxidase
Used for control slides promyelocyte-neutro
Normal bm smear less than 5yo
Color of myeloperoxidase
Brown black deposits
Formula of mpo
P-phenylene diamine + catecol+ h202
Color of chloroacetate esterase
Red deposit
Naphtol asd chloroacetate stable in
Diazonium salt fast corinth
Liberates alpha naphthyl from substrate alpha napthyl acetate
Non specific esterase
Couple dye molecule to form what color
Alpha naphthyl reddish brown
Nse pos in
Monicyte, monoblast, macrophages, histiocytes,nmegakaryocytes
Strongly pos in nse
Abnormal erythroblast
Neg or may show dot positive in nse
Lymphocytes
Chloroacetate specific esterase
Myeloid cell line
Non specific esterase is
Monocyte line
Alpha naphthyl acetate stable in
Diazonium salt fast blue
Alpha naphthyl acetate colo
Brown
Ysed to diff myelomonocytic and monocytic leukemia + from granulocytic leukemia -
Nse
Monocyte nse are
Flouride sensitive
Used for control slides of nse
Appreciable number of monocytes or a normal bm smear
OxidiEs glycogen, moo, and other molecular wt carbo to aldehydes
PAS
This reacts with colorless schiff rgt staining them with what color
Aldehyde bright red pink
Strongly pos in pas
Megakaryoblast and plts
Pas will stain pos
Normoblast
In all show coarse and granular block positivity in pas
Lymphoblast
Neg in pas
Myeloblast
Aids in diagnosis of ALL, erythroleukemia, and megakaryoblastic leukemia
Pas
Pas control slides
Normal bm smear
Pas is composed of
Pas + glycogen
Pas oxidized
Aldehyde + schiff rgt
Schiff rgt is composed of
Para rosalind,na metabisulfite
To indicate a condition that resembles leukekia
Leukemoid leukemia
Leukemoid leukemia increase in
Wbc, hct, shift to the left,n
Leukemoid reaction inc due to
Inflammation
Infection
Intoxication
Some tumor
A leukemoid reaction describe a high
Wbc ct with neutrophilia as infection
Wbc count of leukemoid as high as
50,000 microl mimic cml or aml
This is normal or elevated in leukemoid reaction but is depressed in what dse
Alkaline ohosphatase
CML dse
The blank in leukemoid leukemia of examined may be hypercellular but othewise typucally unremarkable
Bone marrow
Features suggesting leumemoid reaction
Toxic granulation
High LAP score
Presence of an obvious cause for tye neutrophilia
Common dse ass with leukemoid reaction
Whooping cough
Chicken poc
Tb
Pneumonia
Causes of leukemoid reaction
Hemorrhage Drugs Infection Asplenia Diabetic leukoacidosis Organ necrosis
Drugs in leukemoid
Used of dapsonem glucocorticoids, g-csf and all trans retinoic acid
Infection in leukemoid
Clostridium difficile Tb Pertusis Im Vlm
Organ necrosis
Inschemic colitis
Hepatic necrosis
Diff pf leukemoid reaction to leukemia
By leukemoid alkaline phosphatase
The cell that demonstrate a normal griwth will show a high alkaline phosphatase activity
Leukemoid alkaline phosphatase
Color of kaplows found in what
Red brown black precipitates neutro and cytoplasm
Normal cell of kaplows pos precipitate
15-100
Abnormal for leukemia in kaplow
Less than 15
Bone marrow examination
Bm aspirate and trepine biopsy
