Technical Preparation of Bone Marrow Specimens for Histological Assessment (Online Course)

(based on 71 customer ratings)

Brooke Eguia, MS, BS, HT(ASCP), HTL(ASCP)
Reviewer: Diana Harrington, BS, HT(ASCP)

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Continuing Education Credits


  • Recognize the indications for bone marrow examination.
  • Describe optimal technical preparation techniques for blood smears, bone marrow aspirates, and bone trephine biopsies.
  • Discern common bone marrow preparation components.
  • Understand specialized techniques used for bone marrow evaluation.

Customer Ratings

(based on 71 customer ratings)

Course Outline

  • Clinical Indications
      • Bone Marrow Examination: Clinical Indications
      • A common clinical indication for performing a bone marrow biopsy examination used to evaluate pervasive (wide spread) disease is anemia?
  • Bone Marrow Procurement
      • Bone Marrow Procurement
      • Bone Marrow Procurement: Supplies
      • Bone Marrow Procurement: Aspirate
      • Bone Marrow Procurement: Core Biopsy
      • Aspirate: Optional Immediate Bedside Smear Preparation
      • Core Biopsy: Optional Immediate Bedside Imprint Preparation
      • In adult patient populations, what is the preferred site for the collection of bone marrow aspirates and biopsies?
      • The sequence of bone marrow aspiration and bone biopsy sampling is always the same; the bone marrow biopsy sample is ALWAYS collected first.
  • Bone Marrow Core Imprints
      • Bone Marrow Core Imprints (Touch Preparation)
  • Bone Marrow Aspirate Preparation: Anticoagulated Sample
      • Anticoagulated Aspirate Sample: Bone Marrow Layers
      • Occasionally, the percentages of the bone marrow "crit" are difficult to discern and re-centrifugation might help.
  • Bone Marrow Aspiration: Laboratory Technical Preparation
      • Myeloid-Erythroid (M-E) cells/Concentrate/Buffy Coat Smears
      • To prepare the myeloid-erythroid (ME)/concentrate/buffy coat smears, a clean pipette should be used to make the concentrate. After pipetting off the e...
  • Bone Marrow Clot Preparation
      • Bone Marrow Clot Preparation
      • The clot section includes the remaining particles from the aspirate as well as red blood cells. Three levels, usually cut at 3 microns thick, are stai...
  • Bone Marrow Core Biopsy
      • Bone Marrow Core Biopsy
      • Bone marrow core biopsy specimens do NOT allow for the best evaluation of bone marrow cellularity, cellular distribution, and cellular relationships a...
  • Iron Stain on Spun Bone Marrow Aspirate Fat-Perivascular Layer
      • Iron Stain on Spun Bone Marrow Aspirate Fat-Perivascular (F-PV) Layer
      • In order to not disrupt fat cells, alcohol fixation of the fat-perivascular (F-PV) slide used for iron store evaluation with the Prussian blue iron st...
  • Iron Stain on Bone Marrow Concentrate (Myeloid Erythroid Layer)
      • Technical Preparation of Iron Stain on Bone Marrow Concentrate (Myeloid-Erythroid Layer)
  • Immunohistochemical (IHC) Stains
      • Metastatic Carcinoma Immunohistochemical (IHC) Stains
      • CD138 Immunohistochemical (IHC) Stain
      • CD34 Immunohistochemical (IHC) Stain
      • CD117 or Mast Cell Tryptase Stains
  • Special Stains
      • Reticulin Stain
      • Prussian Blue Iron Stain
      • Bacterial and Fungal Stains
      • Amyloid Stain
      • Amyloid deposits are most commonly identified on core biopsy specimens, but may also be seen on aspirate smears.
      • Which stain is commonly utilized to detect iron in bone marrow specimens?
  • Histochemical Stains
      • Enzyme Stains
      • The application of enzyme/histochemical stains by the pathologist will NOT change the classification of the disease in a bone marrow biopsy specimen s...
  • Esoteric Testing
      • Esoteric Testing
  • References
      • References

Additional Information

Level of instruction: Basic to intermediate
Intended audience: Clinical laboratory histotechnologists, histotechnicians, and other medical laboratory personnel who have an interest in this subject matter. This course is also appropriate for histology and clinical laboratory science students, pathology residents, and practicing pathologists.
Author information: Brooke Eguia, MS, BS, HT(ASCP), HTL(ASCP) is the Pathology Technical Supervisor at Fairview Southdale Hospital in Edina, Minnesota. She graduated from St. Cloud State University with a Bachelor of Science degree in general biology and from Capella University with a Master of Science in Human Service with a specialization in Health Care Administration. During her time as an undergraduate, Brooke's interests and studies focused on histologic techniques and gross anatomic dissection. Her senior year, she co-authored for aquatic toxicology research that Aquaculture published in January 2009. Acting as a primary health career mentor to high school students, Brooke satisfied her desire for training and teaching histotechnicians and also worked as adjunct faculty at Rasmussen College, as a Medical Assistant laboratory techniques instructor. Most recently, she has focused on proctoring histology students in clinical/classroom progress and exam preparation.
Reviewer information: Diana Harrington, BS, HT(ASCP) is a histotechnologist at The Dermatology Center of Indiana. Since graduating from Indiana University, she has worked in various hospital laboratories as a medical technologist and histotechnologist. Her experience led her to teach IU students as a Clinical Education Supervisor and create the Histotechnology Program as Program Director for Keiser University in Florida.
Course description: This course provides information about the clinical indications for bone marrow examination and detailed instruction for the preparation of bone marrow smears used for histological testing. 

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Bone Marrow 1

<strong>Particle crush step 1</strong>

Image 1

Bone Marrow 21

Reticulin stain on bone marrow core biopsy section

AD09-173 Bone Marrow Toxoplasma g.
Case of disseminated Toxoplasmosis infection in bone marrow from a heart transplant patient demonstrated with Toxoplasma gondii mouse monoclonal antibody, clone TP3. DAB chromogen.