骨髓细胞学检查026课件.pptVIP

骨髓细胞学检查 Bone Marrow Examination (BME) contents The developmental sequence of marrow cells Indications and contraindications of bone marrow examination Specimens collection Steps of bone marrow examination Report and evaluation of bone marrow examination The developmental sequence of marrow cells Development of progenitor cells 原红细胞 早幼红细胞 中幼红细胞 晚幼红细胞 红细胞 normoblast basophilic polychromatic orthochromatic erythrocyte normoblast normoblast normoblast 原粒细胞 早幼粒细胞 中幼粒细胞 晚幼粒细胞 杆状核 分叶核 myeloblast promyelocyte myelocyte metamyelocyte stab segmented 嗜酸性 嗜碱性 原单核细胞 幼单核 单核细胞 原巨核细胞 幼巨核细胞 颗粒型巨核细胞 产血小板型巨核细胞 血小板 原淋巴细胞 幼淋巴细胞 淋巴细胞 Indications of bone marrow examination Diagnose hematologic diseases -Definitive diagnosis： leukemia， multiple myeloma(MM) -Helpful diagnosis： idiopathic thrombocytopenic purpura(ITP) Diagnose non-hematologic diseases -Metabolic disorders：Gaucher’s disease， Niemann-Pick disease -Metastasis cancer Differential diagnosis of unexplained fever，enlarged liver，enlarged spleen etc. Special consideration Contraindication：severe bleeding disorders，for example hemophilia Specimens collection Marrow aspiration Marrow biopsy Steps of bone marrow examination BME under low power BME on oil lens BME under low power Assesment the degrees of marrow hyperplasia Count the number of megakaryocytes Observe abnormal cells The degree of  marrow hyperplasia nucleated cells: erythrocytes ratio Active proliferation N:E 1:20 Marked hyperplasia N:E 1:10 Extreme hyperplasia N:E 1:1 Hypoplasia N:E 1:50 Marked hypoplasia N:E 1:200