Bone marrow investigations

Question 1

Two types of bone marrow examination

Answer 1

Aspirate

Trephine

Question 2

Aspirate

Answer 2

Site - Posterior iliac crest or sternum (tibia in infants)

Stains - Romanovsky

Results available - 1-2 hr

Main indication - anaemia, pancytopenia, suspected leukaemia or myeloma

Shows: liquid sample shows morphology (structure, foreign cells)

Question 3

Trephine bioopsy

Answer 3

Site-posterior iliac

Stains - haematoxolyin and eosin; reticulin(silver stian)

Results available - 1-7 days

Main indication- polycaemthia rubra vera , meyloproliferative disorfers, aplastic anaemia

Shows: provides a sloid core of bone and gives assessment of bone marrow cellularity, architecture and the presence of infiltrative disease

Question 4

Pros and cons of aspiration

Answer 4

For

• mild traum
• fast
• relative quantitty of different cell types

Against
-does not distinguish architecture

Question 5

Pros and cons of trephine

Answer 5

For

• represents all cells
• diff cell architecture

Against
- slow processing

Question 6

Stains used in bone aspiration

Answer 6

Romanowsky but prussian blue (detects iron in macrophages)