Bone Marrow Aspiration Part I: Normal Hematopoiesis and Basic Interpretive Procedures (Online Course)
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Author: Marybeth Helfrich, MT(ASCP)
Reviewer: Paul S. Fekete, MD, FCAP
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.
Continuing Education Credits
- P.A.C.E.® Contact Hours: 2 hour(s)
- Florida Board of Clinical Laboratory Science CE - General (Hematology): 2 hour(s)
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.
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Course Outline
Click on a link in the outline to view a sample page from this course.
- Bone Marrow Aspirates
- Sample Collection
- 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 of the following smear techniques can be utilized when processing bone marrow aspirate samples? (Choose 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
- The same staining protocol can be used for bone marrow smears as is used for peripheral blood smears.
- Normal Bone Marrow Morphology
- Bone marrow Differentials
- 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 form:
- Erythroid Maturation Sequence
- Erythrocytic Cells: Introduction
- Pronormoblast (Proerythroblast)
- Basophilic Normoblast
- Polychromatophilic Normoblast
- Orthochromic Normoblast
- 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 / Plasmacells
- 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
- Rules for Bone Marrow Differentials
- Rules for Bone Marrow Differentials, continued
- Rules for Bone Marrow Differentials, continued
- Calculating and Reporting the Myeloid:Erythroid (M:E) Ratio
- Cellularity and Additional Information
- Responsibility of the Technologist versus Hematopathologist
- References
Additional Information
Level of Instruction: Intermediate to Advanced
Intended Audience: Clinical laboratory technologists, technicians, and pathologists. This course is also appropriate for clinical laboratory science students and pathology residents. Author Information: Marybeth Helfrich, MT(ASCP) is currently a Laboratory Technologist Specialist for the Hematology/Oncology Laboratory at Childrens Hospital of Philadelphia. She received her BS, MT from Temple University in Philadelphia and has nearly 40 year experience in both adult and pediatric hematology and oncology settings. She is a regular presenter for ASCLS-PA, 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. Reviewer Information: Paul S. Fekete, MD, FCAP is the President and CEO of MediaLab, Inc. He received his MD from Ohio State University and completed his clinical pathology residency at Emory University in Atlanta. He has served as an Assistant Professor of Pathology at Emory and as the Director of Laboratories for Gwinnett Medical Center in Lawrenceville, GA. He is currently President of Gwinnett Pathology Associates PC, Gwinnett Medical Center. Dr. Fekete is a member of Alpha Omega Alpha Honor Medical Society and a Fellow of the College of American Pathologists. Course information: 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.
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