Bone Marrow Biopsy Report

Sample of a Report

Stanford Hospital and Clinics       300 Pasteur Drive, Stanford, CA 94305

Name: XXXXXXXXXX (CROSSED OUT)

CLINICAL HISTORY: 32-year-old male with a history of APL (SHS-01-29962). A recent biopsy showed no morphologic evidence of residual disease (SHS 01-37736).

ORDER DOCTOR:   MARTIN, BETH

OPERATION:    Bone marrow biopsy

GROSS DESCRIPTION:     The specimen "left PSIC bone marrow biopsy" is received in Bouin's solution and consists of one elongated cylindrical tan-brown fragment of bony material that measures 1.5 x 0.2 x 0.2 cm. The specimen is submitted entirely between sponges in a single cassette following decalcification (MARROW HEME tag). Estrada for Morgan/pal

LABORATORY DATA:

WBC:      6.4 K/uL  

HGB: 11.0   g/dL  

HCT: 34.0 %

MCV: 74.2 fL

PLT: 358 K/uL

RDW: 14.5%  

ABS NEUT: 3.92   K/uL

ABS LYM: 1.70 K/uL

PERIPHERAL BLOOD SMEAR: Red blood cells are normochromic and range from microcytic to normocytic. There is occasional polychromasia. A few scattered teardrop forms are identified. Platelets are normal in number with occasional large and hypogranular forms. -White blood cells are normal in number, with a normal absolute number of neutrophils. White blood cells are predominantly normal appearing segmentged and band neutrophils, with fewer numbers of lymphocytes and monocytes.

BONE MARROW ASPIRATE:      The bone marrow aspirate is adequate. Megakaryocytes are present in normal numbers with normal morphology . The M:E ratio is 2-3:1. Myeloid precursors are normal in number and are left-shifted without a relative increase in the number of promyelocytes or blasts. Erythroid precursors are present in normal numbers and are also mildly left-shifted . Iron stores are present within histiocytes, no ringed sideroblasts are identified.

BONE MARROW BIOPSY:    The bone marrow biopsy is mildly hypercellular for age, approximately 70%. Megakaryocytes are present in normal numbers and morphology. The M:E ratio is 3:1. Myeloid and erythroid precursors are normal in number and mature fully. The myeloid precursors are mildly left-shifted. There are no excess blasts. Notable, there is an area of fibrosis, which appears to be associated with subcortical bone.

COMMENT:   The bone marrow aspirate and biopsy reveal left-shifted myelogenesis and erythrogenesis. There is no relative increase in the number of promyelocytes or blasts. Since morphology is limited in distinguishing normal myelogenesis from residual disease, correlation with cytogenetic and/or molecular studies is recommended.

DIAGNOSIS: BONE MARROW ASPIRATE, BIOPSY, AND PERIPHERAL BLOOD SMEAR MILDLY HYPERCELLULAR MARROW WITH LEFT-SHIFTED MYELOID AND ERYTHROID MATURATION (SEE COMMENT)

MORGAN/NATKUNAM p] 1/24/02 daw/01/24/02 I have personally reviewed the specimen and agree with the interpretation above. YASODHA NATKUNAM M.D. Pathologist Electronically signed 01/24/2002

N

00:00 NULL-USER, YASODHA NATKUNAM,

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Explanations, annotated  by Joe Hing Kwok Chu (source:Atomica-GuruNet):

MARTIN, BETH M.D.

Dr. Martin is one of the two best medical doctors in the field of Leukemia and Multiple Myeloma in United States,  as told by various oncologists, also by Prof. Richard Dorsay M.D., a retired radiologist  who headed the radiology department of South San Francisco Kaiser Hospital for 15 years.

biopsy:

1. The removal and examination of a sample of tissue from a living body for diagnostic purposes.

2. A sample so obtained.

Normochromic red cell: The color of red blood cells that contain a normal amount of hemoglobin

Bouin's fluid:  A fixing and preserving solution consisting of picric acid, formaldehyde, and glacial acetic acid called also Bouin; Bouin's solution

microcyte: An abnormally small red blood cell present esp. in some anemias

normocyte: A red blood cell that is normal in size and in hemoglobin content

polychromatic: 1. Having or exhibiting many colors. 2. Of or composed of radiation of more than one wavelength: polychromatic light.                                                   (Back to top portion of report)

hypogranular: hypo granular cells

megakaryocyte: A large cell that has a lobulated nucleus, is found esp. in the bone marrow, and is the source of blood platelets

lobulated: Made up of, provided with, or divided into lobules the pancreas is a lobulated organ; a lobulated tumor

hy·per·cel·lu·lar·i·ty : The presence of an abnormal excess of cells (as in bone marrow)

morhpology:

1. A branch of biology that deals with the form and structure of animals and plants esp. with respect to the forms, relations, metamorphoses, and phylogenetic development of organs apart from their functions.

2. The form and structure of an organism or any of its parts

See acute promyelocytic leukemia

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Last update: Aug 28, 2013; 5 p.m. LA