BoneMarrowInstituteofMedical: WhatisBoneMarrowBonemarrowexaminationreferstothepathologic ysisofsamplesofbonemarrowobtainedbybonemarrowbiopsy(trephinebiopsy)andbonemarrowaspiration.BonemarrowexaminationisusedinthediagnosisofanumberofandpancytopeniaClinicalApplication＆IndicationsandContraindicationsofBMEThedevelopmentalsequenceofmarrowcells&SpecimenscollectionStepsofbonemarrowReportandevaluationofbonemarrow§1ClinicalApplication＆IndicationsandContraindications （Leukemia）、性血小板②某些非造血系統(tǒng)疾?。喝绡懠病⒑跓岵?、病 2ThedevelopmentalsequenceofmarrowSpecimensBM BM

?Givescellandstroma Givesmaterialtofurtherstudy,e.g.moleculargeneticsandflow ?Explainscauseof"drytap"(aspirationgivesnoblood Slow 取材方

涂片中細(xì)胞分布均勻，胞體舒展，染色良好，較易優(yōu)

缺

§3StepsofbonemarrowBMEunderlowBMEonoil

①Assesmentthedegreesofmarrow②Countthenumberof③Observeabnormal①M(fèi)arrowdifferentialcountof200nucleated②MorphologicexaminationofmarrowThedegreeofmarrownucleatedcells:

Countthenumbersof §4BonemarrowreportandThedegreeofratio（N：E）ExtremeMarkedActiveMarkedExtreme MarkedN:EN:EN:EDegreesofmarrowextrememarkedleukemia,Hyperplasticactivenormalbonemarrow,aplasticmarkedaplasticM:EMyeloidseries:ErythroidtheratioofmyeloidtoerythroidprecursorsinboneNormalValue:normallyvariesfrom2:1toIncreasedratioisfoundininfections,chronicmyelogenousleukemia,orerythroiddecreasedratiomaymeanadepressionofleukopoiesisornormoblastichyperplasiadependingontheoverallcellularityofthebonemarrow.NormalBoneMarrow

cell

cell

Plasmacells：othercellsor

20%ofnucleated＜4%ofnucleated＜2%ofnucleatedcellsMakeaDefinitiveSupportive（cytochemicalIronstain

plasmacyte,redbloodcell,andmegakaryoblast 中性粒細(xì)胞堿性磷酸酶(neutrophilalkalinephosphatase,NAP)染Adult:NAPrate

IronStain（鐵染色低鐵化鉀低鐵化鉀

鐵鐵鐵化鐵沉淀鐵化鐵沉淀①M(fèi)arrowIronStores:Blue-blackstainingmaterial(ironstores)isconcentratedinthereticuloendothelialcellsAABCD②3.3臨床意義（ClinicalIronIronNon-Ironstores>>annualMICM morphology形態(tài) immunology

InstituteofMedical: 身免疫溶血性貧血、地中海貧血、再生性貧血、陣發(fā)性睡眠血紅蛋白尿、失血性貧血、紅細(xì)胞增 §1 AcuteAplastic①RBC、HGB②Ret③WBC:1～2×109/L，Lym④PLTcount:

AcuteAplasticAnemia①M(fèi)arked②M:Eratio③Granulocyte/Erythrocyte/Megakaryocyteextremely④Thepercentageof⑤Plasmacell§2

FAB TheFABclassificationofacutemyeloidCell ClearpromyelocyticAmixtureofgranulocyticandmonocyticClearmonocyticcharacteristicsBlastswitherythroidcharacteristicsBlastswithmegakaryocyticTheclassificationof ymphocytic 病細(xì)胞增生為主，占非紅系細(xì)胞的30%以上常見白血病裂孔現(xiàn)象（emc 即出現(xiàn)大量原始細(xì)胞和少量成熟細(xì)胞，而缺乏中間過渡階段的細(xì)胞，表明白血病細(xì)胞有熟 AM到。 MICM morphology形態(tài) immunology

LL:LL:CD2,CD5,CD33,41,42, AML-AML1-MTGCBFβ-MYH慢性粒細(xì)胞白血病的血象和骨髓象表白細(xì)胞形態(tài)和數(shù)量異常。多在30×0/，分類以中幼粒細(xì)胞以下各+早幼粒細(xì)胞0%%，嗜酸性粒細(xì)胞可增多?！?Idiopathicthrombocytepenicpurpura,是一種常見的性疾病。系由于患者體內(nèi)產(chǎn)生抗血小板抗體，致使血小板縮短，破壞增加，骨髓中巨核細(xì)胞的成熟和產(chǎn)血小板的功能受到抑制，從而導(dǎo)致皮膚、粘膜等一系列表現(xiàn)。根據(jù)臨MarkedhyperplasiaThrombocytogenousmegakaryocyteAcuteITP:ChronicITP:granular§4 多發(fā)性骨髓（Multiplemyeloma,