The Illustrated Guide to Bone Marrow Diagnosis [antikvár]

Introduction Bone marrow core biopsies introduced in the late 1950s have enabled pathologists to diagnose a wide range of hematopathological disorders. Most biopsies are taken from the posterior superior iliac spine and should be at least 1 cm in length. The advantages of a trephine over an aspirate are in showing the topography and cellularity of the marrow. Furthermore, in diseases which produce fibrosis, e.g. Hodgkin's disease, an aspirate often fails to produce an adequate diagnostic sample ('a dry tap"). Close liaison with hematologists is important since it makes the reporting of trephine biopsies easier and ensures that misdiagnoses are kept to a minimum. Biopsies may be embedded in plastic or in paraffin wax with prior decalcification. The latter is most suitable for a routine laboratory and is used throughout this pocket book. In this book both Giemsa and H&E counterstains are illustrated. When indicated, we include a reticulin stain in our bone marrow set. Reasons for performing bone marrow biopsies The majority of bone marrow biopsies are performed for the following reasons: 1. Dry tap, usually caused by fibrosis or extreme hypercellularity 2. Assessment of cellularity 3. Identification of focal disease 4. Lymphoma staging 5. Assessment of HIV infection How to examine a trephine section It is important to have an organized approach to the examination of bone marrow sections and to assess sequentially cellularity, topography, morphology and accessory structures. The bone marrow is a highly organized and specialized tissue. Confidence in examining a trephine biopsy is derived from a familiarity with the normal marrow appearances and an understanding of how these alter throughout life.