Bone Marrow Flashcards
When would a bone marrow aspirate be indicated?
non-regenerative anemia
neutropenia
thrombocytopenia
suspected neoplasia or monoclonal gammopathy
classification of leukemia
Where can bone marrow samples be taken?
Trochanteric fossa
humerus
wing of the ilium (but we don’t like this one)
If not making slides within 20 seconds, what should the syringe be washed with before aspirating the marrow?
EDTA
If a bone marrow aspirate is not possible, a core biopsy can be sent to the lab for determining cellularity. What is the limitation of this method?
Can’t tell differentiation of blast cells
T/F: Push method is best for bone marrow aspirates, and to do this you need at least 0.5ml of marrow in the syringe.
FALSE to both
Do a pull film for marrows. Too fragile for push.
Only aspirate a few drops, otherwise you’re contaminating the sample with blood.
What can we tell from bone marrow aspirates?
cellularity
presence of megakaryocytes (7-10 ok)
presence of iron stores
myeloid:erythroid ratio
orderliness/completeness of maturation
other cells (plasma cells)
abnormal cells
microorganisms (rare)
What features make this bone marrow aspirate healthy?
Adequate cellularity
Variety of R/W BCs
Complete differentiation
Megakaryocyte
A marrow aspirate in which most neutrophil precursors are very young, and there are no bands or segs, is indicative of what?
Consumptive disease
How does this bone marrow aspirate look?
Inadequate cellularity
Bone marrow film on a dog with anemia. What kind of anemia is on the differential?
Fe++ deficiency anemia
Anemia of inflammatory disease
*Iron stores present
At what stage of maturation do the secondary granules develop and differentiate between eosinophils and basophils?
Myelocyte
What is an acceptable myeloid:erythroid ratio for the bone marrow?
1:1 up to 3:1
You perform a bone marrow aspirate on a patient and find that the M:E ratio is significantly increased. What are the possible causes for this?
Erythroid hypoplasia/aplasia
Granulocytic hyperplasia
Granulocytic leukemia (increased myeloblasts)
A bone marrow aspirate on your patient shows a decreased M:E ratio. To determine if the shift involves the neutrophils or erythrocytes, you check the lab work, which shows a PCV of 20% (35-45), and a neutrophil count of 12,000 (3,000 - 11,000). What is the most likely cause of the change in ratio?
Regenerative anemia
PCV shows anemia, and there is an increase in immature RBCs. The neutrophil count is acceptable (not a decrease in neutrophil production). The shift is likely due to increased production of RBCs in response to the anemia.
*Another cause for dec M:E could be erythroid leukemia
Cell maturation in the bone marrow should be complete and orderly, which means we should see what types of cells?
Polychromatophils, mature RBCs, Bands, Segs
Plasma cells can be up to 2% of cells in the bone marrow. An increase in these cells can indicate what?
Presence of Ag
Multiple myeloma
Presence of these cells in the bone marrow can indicate what pathology?
Osteosarcoma
*These are osteoblasts
What are these cells?
Mott Cells
Plasma cells with vacuoles contining immunoglobulin that is never released.
This bone marrow aspirate from a dog can indicate what?
Mast cell tumors
This is too many mast cells in the bone marrow
Marrow aspirate from a sick and anemic dog. What is the disease?
IMHA
Macrophages in the bone marrow phagocytizing RBCs
A bone marrow aspirate on a sick dog living in the Ohio River Valley shows these inclusions, with clear capsular zones around them, in the macrophages. What is the pathogen?
Histoplasma capsulatum
A bone marrow aspirate on a domestic cat shows these banana shaped parasites. What are they?
Toxoplasma gondii
A bone marrow aspirate on a dog with granulomatous dermatitis shows these cells, each with a round and rod shaped structure within them. What is the pathogen?
Leishmania
A bone marrow aspirate on a dog shows these circular structures within the RBCs. What is the pathogen?
Babesia
