Bone Marrow Aspiration: Normal Hematopoiesis and Basic Interpretive Procedures
Continuing Education Credits
This course provides a thorough review of cellular elements encountered in normal bone marrow. It also provides guidelines for preparation of smears, including an instructional video, and evaluation and reporting of bone marrows.
Objectives
- Describe bone marrow sample collection, smear preparation, and routine staining techniques.
- Recognize and identify myeloid and erythroid precursors found in normal bone marrow aspirates.
- Compare lymphocytes, hematogones, and plasma cells.
- Compare and contrast monocytes, monocyte precursors, and macrophages.
- Describe benign background cell types found in normal bone marrow.
- Outline and explain standard procedures for reporting bone marrow differentials.
Course Outline
- Bone Marrow Aspirates
- Introduction to Bone Marrow Aspirates and Biopsies
- Bone Marrow Biopsy
- Bone Marrow Aspirate and Biopsy Collection
- Clinical Laboratory's Role: Bone Marrow Aspirates and Biopsies
- In which of the following situations would a bone marrow aspirate and biopsy possibly be used as an aid for diagnosis? Select all that apply.
- Sample Collection
- Bone Marrow Collection: Patient Bedside
- Bone Marrow Delivery
- The role of the laboratory professional in processing bone marrow aspirates can vary depending on laboratory and clinician protocols. Which of the following roles may be performed by a laboratory professional? Select all that apply.
- Smear techniques
- Bone Marrow Smear Preparation
- Bone Marrow Smear Preparation: Selecting Fragments
- Long Slide Preparation Techniques: Wedge Smear
- Long Slide Preparation Techniques: T-prep
- Long Slide Preparation Techniques: Pull Prep
- Coverslip Smear Preparation Technique
- Biopsy Touch Preparation Technique
- Bone Marrow Smear Techniques Video
- Which smear technique can be used when processing bone marrow aspirate samples? Select all that apply.
- Routine Staining
- Manual Staining of Bone Marrow Preparations
- Manual Staining of Bone Marrow Preparations: Wright's and Wright-Giemsa Stain
- Automated Stainers
- Iron Staining
- True or False? The same staining protocol for peripheral blood smears can be used for bone marrow smears.
- Normal Bone Marrow Morphology
- Bone Marrow Differentials
- Rules for Bone Marrow Differentials
- Rules for Bone Marrow Differentials, continued
- Rules for Bone Marrow Differentials, continued
- Myeloid Maturation Sequence
- Myeloblast
- Promyelocyte
- Myelocyte
- Myelocytes: Eosinophils and Basophils
- Metamyelocyte
- Band Neutrophil
- Segmented Neutrophil
- Place the following stages of neutrophilic granulocyte cellular development in the correct order of maturation, beginning with the earliest recognizable form.
- Erythroid Maturation Sequence
- Erythrocytic Cells: Introduction
- Pronormoblast (Proerythroblast)
- Basophilic Normoblast
- Polychromatophilic Normoblast
- Orthochromic Normoblast
- True or False? When performing bone marrow differentials, it is not necessary to distinguish the precursor forms of the erythroid sequence.
- Monocytes/Macrophages
- Monoblast
- Promonocyte
- Monocyte
- Macrophage (Histiocyte)
- Hemophagocytosis
- Lymphocytes/Hematogones/Plasma Cells
- Lymphocyte
- Hematogone
- Plasma Cell
- What are the cells that are indicated by the red arrows in the image on the right?
- Megakaryocytes
- Megakaryocyte: Immature
- Megakaryocyte: Mature
- Other Constituents of Normal Bone Marrow
- Osteoclast
- Osteoblast
- Stromal Cells
- Bone Marrow Evaluation and Reporting
- Calculating and Reporting the Myeloid:Erythroid (M:E) Ratio
- Cellularity and Additional Information
- Responsibility of the Laboratory Professional versus the Hematopathologist
- References
- References
Additional Information
Level of Instruction: Intermediate to Advanced
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Marybeth Helfrich, MLS(ASCP) is currently a Laboratory Technologist Specialist for the Hematology/Oncology Laboratory at Children's Hospital of Philadelphia. She received her BS, MT from Temple University in Philadelphia and has nearly 40 years of experience in both adult and pediatric hematology and oncology settings. She is a regular presenter for ASCLS-PA and has been a presenter for ASCP (local and national) and the Texas Teleconference network. She is responsible for hematology morphology instruction and training for medical technologists and fellows. She is also a regular developer of morphology tutorials for in-house continuing education activities.
The author has no conflict of interest to disclose.
Reviewer Information:
Patricia Boyer, MSHS, MLS(ASCP)CM is the Program Director of the Zablocki VAMC School of Medical Technology and an adjunct professor at Marquette University and the University of Wisconsin-Oshkosh. She has a Master of Science in Health Sciences with an emphasis on professional education. She currently teaches in the areas of hematology, transfusion medicine, and hemostasis.
Judi Bennett, BSM, MLS(AMT), MLT(ASCP), is an Education Developer with MediaLab by Vastian, bringing over 30 years of experience as a medical laboratory scientist. Before joining MediaLab in 2010, she held key leadership roles, including Clinical Laboratory Manager, Microbiology Supervisor, and Senior Systems Analyst at Gwinnett Health System in Lawrenceville, Georgia. Her extensive knowledge of laboratory operations, combined with a strong commitment to healthcare quality and education, fuels her passion for developing engaging and effective learning tools for the next generation of laboratorians.
Course information: This course provides a thorough review of cellular elements encountered in normal bone marrow. It also provides guidelines for the preparation of smears, including an instructional video and evaluation and reporting of bone marrows.