(P) Week 2: Bone marrow and Lymphoid Organs Part 2 Flashcards
this is where the lymph fluid collected from tissues flows
lymph nodes
when blood flows into the capillaries, ________ leaks through them which now circulates into the lymphatic vessels
plasma
_________ filters plasma from the lymph fluid before it is returned to the general circulation
lymph nodes
what are the three layers of the lymph nodes
cortex, paracortex, and medulla
this is the germinal center of the lymph nodes where activated B-cells lie
cortex
this is the layer of the lymph node that contains t-cells and macrophages
paracortex
what does the medulla contain?
b-cells and plasma cells
what is the sample used for:
diagnosing leukemia
assess marrow function
assess iron storage
to rule out other hematological diseases
bone marrow
T or F
you may not collect bone marrow samples when there’s a quantitative issue with the platelet
F (you may because there’s only a problem with platelet amount)
T or F
Qualitatve platelet issues disqualifies a patient for a bone marrow collection procedure
T
T or F
Spleen problems is a ground for rejection for a bone marrow collection procedure
F (liver problems)
T or F
Hemophilia A and B is a contraindication to collect bone marrow
T
T or F
Vitamin C deficiency is a contraindication to collect bone marrow
F (vit K)
Enumerate the prothrombin group clotting factors that are dependent on vitamin K
CL 2,7,9, and 10
Bone Marrow specimen
Place in zenker’s fluid,
buffer-neutral formalin
and B5 fixative
Bone marrow core biopsy
how much Bone marrow aspirate must be collected
1-3 mL
this is done when there is difficulty in aspirating a sufficient amount of bone marrow aspirate
dry tap
what are the acceptable preparations of bone marrow aspirate to be submitted to a doctor upon routine staining
direct films and crush preparations
Bone Marrow specimen
Stained with either
* Romanowsky stain
* Wright-Giemsa stain
* Prussian blue stain
Bone Marrow aspirate
what anticoagulant is used in bone marrow samples?
EDTA
enumerate the process of re-clotting the bone marrow aspirate in an EDTA tube
- 0.15 M of calcium chloride
*place in fixative ex. Zenker’s formalin - submit to the histotech lab for tissue processing
instrument used to bore a hole into the bone for bone marrow collection
trephine biopsy needle
anticoagulant used for bone marrow specimens that will be undergoing routine examination
EDTA
anticoagulant used for bone marrow specimens that will be undergoing special examination
heparin
what are the 2 kinds of leukemia under special stains for blood and bone marrow
acute myelogenous leukemia (AML)
acute lymphoid leukemia (ALL)
What are the stain results for AML?
peroxidase =
sudan black b (SBB) =
tDT =
peroxidase = +
sudan black b (SBB) = +
tDT = -
What are the stain results for ALL?
peroxidase =
sudan black b (SBB) =
tDT =
peroxidase = -
sudan black b (SBB) = -
tDT = +
type of esterase stain that stains monocytes, monoblasts, promonocytes, and megakaryocytes
non-specific
type of esterase stain that stains all immature granulocytes and granulocytes
specific
type of esterase stain that differentiates granulocytic and non-granulocytic leukemia
specific
non specific esterase stain is divided into
alpha-napthyl-butyrate
alpha-napthyl-acetate
other name for specific esterase stain
ASD-chloroacetate esterase
granulocytic or non-granulocytic leukemia
monoblasts, promonocytes, and monocytes
will become macrophage
non-granulocytic
granulocytic or non-granulocytic leukemia
myeloblasts, promyelocytes, etc
granulocytic
how many types of acute myeloid leukemia are there?
8 (0-7)
how many types of acute myeloid leukemia can esterase differentiate
5 (M1-M5)
these are all purely granulocytic
specific esterase = +
non-specific esterase = -
M1, M2, M3
combined granulocytic and non-granulocytic
specific esterase = +
non-specific esterase = +
M4
purely non-granulocytic
specific esterase = -
non-specific esterase = +
M5
Used to differentiate leukemoid reactions from leukemia
Leukocyte alkaline phosphatase (LAP)
High LAP reactions indicate
leukemoid
0 to decreased (-) LAP reaction
leukemia
Used to diagnose and confirm hairy-cell leukemia (targets B cells)
Tartrate-Resistant Acid Phosphatase (TRAP)
This stains iron
pearl’s / Prussian blue stain
rubricytes or immature RBCs with excess amounts of iron
Sideroblasts
mature RBCs that got into the general circulation with excess iron
Siderocytes
RBC made up of aggregated granules aka _______________ are made up of iron, and therefore stained with Pearl’s stain
pappenheimer bodies
Used to diagnose chronic granulomatous disease
Nitroblue Tetrazolium Stain (NBT)
A condition wherein engulfed organisms cannot be killed off by the macrophage due to its impaired killing ability
chronic granulomatous disease
There is a deficiency with the _________enzyme which makes the respiratory or oxidative bursting function of phagocytes defective in chronic granulomatous disease
NADPH oxidase
Normal phagocytes should produce _________ (precipitates) with Nitroblue Tetrazolium Stain (NBT)
blue-black formazan
Nitroblue Tetrazolium Stain (NBT)
no staining indicates
abnormal phagocytes
study where in the bone marrow liquid is placed in an ESR tube and spun to determine the levels of fat and buffy coat on each layer
macroscopic cellular study
Normal values for fat and buffy coat in macroscopic cellular study
Fat - 1-3%
Buffy Coat - 3-5% or 5-8%
if the levels fall between the reference values, the patient is evaluated as ____________
normocellular
conditions that manifest ___________
Aplastic anemia
Bone marrow failure
Fanconi syndrome
Myelofibrosis
hypocellularity
what do you call congenital myelofibrosis?
Myelofibrosis with Myeloid Metaplasia (MMM)
what do you call myelofibrosis if the cause is unknown?
Idiopathic Myelofibrosis
conditions that manifest ___________:
Leukemia (chronic or acute)
Polycythemia vera
Leukemoid reactions (severe cases)
Megaloblastic anemia
hypercellularity
magnification used to find
fat to marrow ratio (cellularity estimate)
tumor cells
megakaryocyte number estimates
Low power 100x
magnification used for
differential count
myeloid: erythroid (M:E) ratio computation
identify abnormal distribution and maturation gaps of cells
High Power (500X to 1000X Magnification)
a reversed M:E ratio (erythroids are more than the myeloids) presents in
erythroleukemia (aka AML M6)
when myeloids overpower the erythroids in number, it presents
granulocytic leukemia or chronic myelogenous leukemia
How many metamegakaryocytes are normally found in every LPO?
2-10
Osteoclasts VS Metamegakaryocytes
have separated nuclei and do not have cytoplasmic granules
Osteoclasts
Osteoclasts VS Metamegakaryocytes
have fused nuclei with cytoplasmic granules
Metamegakaryocytes
Osteoblasts VS Plasma cells
have perinuclear halos near the nucleus
Plasma cells
In the bone marrow biopsy specimen, the RBC precursors were estimated to account for 40% of the cells in the marrow, and the other 60% were granulocyte precursors. What is the M:E ratio?
Sol.: simply divide the higher number with the lower number (60%/40%= 1.5)
1.5:1
If see this card gib nath a kith
thanks mwah