Hematology Question 14 Instructor

List the indications for a bone marrow biopsy. What investigations can be collected from a bone marrow aspirate and biopsy?

Indications for a bone marrow biopsy:

  • Evaluation of anemia or a cytopenia NYD
  • Staging for lymphoproliferative disorders
  • Diagnosis of hematologic malignancies including AML, myeloma, MDS, and MPNs
  • Gold standard for evaluation of iron stores
  • Evaluation of other diseases (i.e. macrophage activation syndrome, storage disease) or infections

Distinguish the differences of an aspirate compared to a biopsy.

Investigation Bone Marrow Aspirate Bone Marrow Biopsy
Cytology Ensure spicules in collection

Allows assessment of bone marrow cellularity and cytology of cells

Preferred 2cm length of biopsy

Assesses bony architecture

Flow cytometry Allows for evaluation of diagnosis and clonality re identification of CD markers (i.e. in leukemias and lymphomas) Not routinely done on a biopsy specimen

Can try to obtain if separate biopsy specimen is placed in a sterile medium

More common: Perform immunohistochemistry stains on biopsy material

Cytogenetics Evaluate chromosomal aberrations (i.e. deletions, translocations)

Imperative to be collected for AML, ALL, CML, CLL, MM, MDS, and certain lymphoproliferative disorders

Can try to obtain if a separate biopsy specimen is placed in a sterile medium
Molecular studies PCR based testing

Must be collected in suspected cases of acute leukemia, CML, and myeloproliferative neoplasms

Can try to obtain if a separate biopsy specimen is placed in a sterile medium

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