CytologicalexaminationofBM.pdf

Cytological Examination of Bone Marrow Department of Clinical Laboratory Peking University First Hospital Content • Application sheet • Microscopic examination • Summary Microscopic examination • Low power field • Oil immersion field Microscopical examination of the smear • Low-power examination – Assessing the slide – Assessing the cellularity of bone marrow – Megakaryocyte count – giant cells or abnormal cells • Oil-immersion examination The different smears of bone marrow Staining well or badly Different sites of the smear The cellularity of bone marrow Microscopical examination of the smear • Low-power examination • Oil-immersion examination – Morphological recognition of the various types of hematopoietic cells, including granulocytes, erythroid cells, lymphocytes, monocytes, megakaryocytes, plasma cells and other cells – Differentiating count of 200-500 nucleated cells – Myeloid-erythroid ratio (M:E) – Morphology of mature erythrocyte Morphology characteristics • Cell size • Nucleus-plasma ratio • Nuclear characteristics • Plasma characteristics 血细胞分化、发育、成熟的形态变化规律 The special cells in bone marrow a: fatty cell, b: tissue eosinophilic cell, c: d: macrophage, e: osteoblast Some abnormal cells in bone marrow Niemann- Gaucher cell Lung cancer cells Erythroid series Granulocytic series Plasma cell Granular megakaryocyte Thrombocytogenous megakaryocyte To recognize • Promyelocyte • Myelocyte • Metamyelocyte • Basophilic normoblast • Polychromatic normoblast • Orthochromatic normoblast • Plasma cell • Megakaryocyte Reference range –Myeloid: 40%~60% –Erythroid: 20% –M:E (2~4):1 –Lymphocyte: 20% –Monocyte: 4%