Bone Marrow Analysis Zhao xindong
description
Transcript of Bone Marrow Analysis Zhao xindong
![Page 1: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/1.jpg)
Bone Marrow Analys
is
Zhao xindong
![Page 2: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/2.jpg)
I. Degrees of marrow cellularity
A.Marked or Moderate Hypercellularity
1.Malignant proliferation of abnormal cells
2.Hemopoietic hyperplasia
(1)Hyperplastic anemia
(2)Mageloblastic anemia
![Page 3: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/3.jpg)
![Page 4: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/4.jpg)
![Page 5: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/5.jpg)
B.Hypercellularity
1.Normal BM 2.Certain anemias
![Page 6: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/6.jpg)
C. Hypocellularity
1.Hemopoietic depression
2.Marrow diluted by blood
![Page 7: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/7.jpg)
Differential Diagnosis Hypoplasia BM diluted Naked eye BM granules * Rarely visible or fatty dropMicroscopy Specific cells * Rarely visible of BM Band >segmented * Band < segmented
Hemopoietic cells Hemopoietic islands, MegakryocytesNonhemopoitic cells Plasma cell,Mast cell Osteoblast, Osteoclast
![Page 8: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/8.jpg)
II.M/E ratio1.M:E= ↑( ≥ 5:1)
(1)M ↑ :Infection,leukemoid reaction, AML,CML(2)E ↓ :Pure red cell aplasia ( PRCA)
![Page 9: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/9.jpg)
2.M:E = N (3~4:1 )(1)Normal marrow(2)M ↑:E ↑ =N. Erythroleukemia,
Polycythemia vera (PV ), CML
(3)M ↓:E ↓ =N. AA, Myelofibrosis, MM,ALL
![Page 10: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/10.jpg)
3.M :E = ↓ (≤ 2:1 ) or inversion
(1)M↓: leukopenia, Neutropenia
(2)E ↑: Hyperplastic Anemia
MA,PV,Erythremia.
![Page 11: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/11.jpg)
![Page 12: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/12.jpg)
Targets of Myeloid Hyperplasia
1.Degrees of marrow cellularity.
2.Myeloid to erythroid ratio
3.Myeloid mitotic cells
4.Myeloid series occupy %
of all nucleated cells.
![Page 13: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/13.jpg)
Morphologic Abnormalities
of Myeloid series
1.Abnormal cell
2.Abnormal nucleus
3.Abnormal Cytoplasm
![Page 14: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/14.jpg)
1 、 Abnormal cell
(1)Abnormal shape
(2) Development of nucleus and cytoplasm is disproportionate
2 、 Abnormal nucleus
(1)Pelger-huet anomaly
(2) Degeneration of nucleus
(3) Hypersegmented neutrophils
![Page 15: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/15.jpg)
Pelger-Huet anomaly: All of the neutrophils have no more than a bi-lobed nuc
leus. The nuclear chromatin is coarsely clumped. It may be found in CML,MDS or inherited.
![Page 16: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/16.jpg)
Hypersegmented neutrophils
![Page 17: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/17.jpg)
3 、 Abnormal cytoplasm
(1) Toxic granules
(2)Vacuoles (3) Dohle bodies: Inclusion body, a small light blue-staining area in cytoplasma of neutrophil,is found in infections, poisoning, burns following chemotherapy.
![Page 18: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/18.jpg)
(4)Auer rods:
are rod-like bodies that stain a reddish purple, they are found only in the cytoplasm of the blast cells in acute monocytic or acute myelogenous leukemia or MDS-RAEBt
![Page 19: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/19.jpg)
Myeloid Hyperplasia
--Myeloblasts ↑:AML,CML-CP, AMMoL
-- Promyelocytes ↑ :APL
-- Myelocytes ↑:M2b
-- Metamyelocytes and Bands ↑:CML
![Page 20: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/20.jpg)
Myeloid Hyperplasia
-- Eosinophilic Granulocytes ↑ Allergic conditions Parasitic infections eosinophilic leukemia chronic myelocytic leukemia
![Page 21: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/21.jpg)
Myeloid Hyperplasia
--Basophilic Granulocytes ↑
basophilic leukemia
chronic myelocytic leukemia
![Page 22: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/22.jpg)
B o r r o w m a r r o w E x a m i n t i o n
Myeloid Hypoplasia
Neutropenia: hypoplasia, mature suppression.Aplastic Anemia. Aplastic Crisis.
![Page 23: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/23.jpg)
Erythroid Hyperplasia
Pronormoblast,Early normoblasts↑: EL Polychromatic normaoblasts and Orthochromatic normaoblasts ↑ : HA,IDA,MA Orthochromatic normaoblasts ↑:IDA
![Page 24: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/24.jpg)
![Page 25: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/25.jpg)
Targets of Erythroid Hyperplasia.
Degrees of marrow cellularity.Myeloid to erythroid ratioErythroid mitotic cellsNormoblasts occupy % of all nucleated cells.
![Page 26: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/26.jpg)
Targets of Erythroid Maturation.
Late normoblasts ratio in erythron
Absolute reticulocytes in blood
RBC in blood.
![Page 27: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/27.jpg)
![Page 28: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/28.jpg)
![Page 29: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/29.jpg)
Erythroid Hypoplasia
Aplastic Anemia( AA)
Pure Red Cell Aplasia( PRCA)
Acute Arrest of Hemopoiesis. ( AAH)
![Page 30: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/30.jpg)
Hyperplasia of Megakaryocytic Serie
s Megakaryblasts
>30% Ameg- L .
Megakaryocytes
CML,PV, Acute Hemorrhage.
Megakaryocytes with mature
depression.
ITP, Evan Syndrome
![Page 31: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/31.jpg)
![Page 32: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/32.jpg)
Hypoplasia of Megakaryocytic Series
-- Acute leukemia --AA --Myelofibrosis
![Page 33: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/33.jpg)
Lymphocyte Series
1.Lymphoblast and prolymphocyte (1)ALL (2)crisis of CLL (3)Mixed acute leukemia (MAL) (4) Crisis of CML (5) Prolymphocytic leukemia (PLL) (6)Lymphoma
![Page 34: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/34.jpg)
2.Lymphocyte (1) CLL (2)Leukemoid reaction (3)Infectious mononucleosis(IM) (4)Infectious Lymphocytosis (5)Virus Infections
![Page 35: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/35.jpg)
Monocyte series
1.Monoblast (1)Acute monocytic leukemia (AMOL) (2)Acute Myelomonocytic leukemia (AMMOL)
![Page 36: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/36.jpg)
2.Promonocyte
(1) Acute monocytic leukemia
(2) MDS-CMMOL
(3)Malignant tumor.
![Page 37: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/37.jpg)
Monocyte series
3.Monocyte (1) Leukomoid Reaction
(2) maligant tumor
![Page 38: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/38.jpg)
Plasmatic series 1.Plasmablast and Proplasmacyte
(1)Multiple Myeloma (MM)
(2) Plasma cell leukemia (PCL)
2.Plasmacyte
(1)ITP (2) AA (3)Waldenstron’s macroglobulinemia
![Page 39: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/39.jpg)
![Page 40: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/40.jpg)
![Page 41: Bone Marrow Analysis Zhao xindong](https://reader035.fdocuments.net/reader035/viewer/2022062423/568144e8550346895db1b8ce/html5/thumbnails/41.jpg)
Histocytosis
(1)Malignant Histocytosis(MH)
(2)Histocytic type Lymphoma
(3)Infectious diseases