HOW TO Diagnose BM Smear 1-You have to start with peripheral blood film examination as it is the key for many

hematological disorders such as MDS (pancytopenia, macrocytes, hypogranularity and hyposegmenation of granulocytes). 2-To examine BM start with low power (10x) otherwise you may miss the following:

Significant Increase in megakaryocytes if there is thrombocytopenia: -ITP/hypersplenism

BM infiltration such as : -Non hematopoietic -Neuroblastoma -Gaucher

Aplastic anemia Hypoplastic particles, hypocellular trails, You will notice increase in lymphocytes, plasma cells macrophage and by oil immersion lens

Oil Immersion Lens ch Increased Myeloid Series -MPN/leukemoid reaction Ask for NAP score and t(9;22). Increased Erythroid 1-Anemia 2-MDS blasts of non erythroid<20% 3-M6 blasts of non erythroid >20% Increased lymphocytes I-LPD CLL/Lymphoma Do IPT on Pb/BM II-Viral infection 2-Plasma cell dyscrasia (MM) Increased plasma cells 1-Reactive (3.510%) Aplastic anemia, Hodgkin lymphoma, Liver disease Blasts >20%

Acute leukemia

If the promyelocytes are predominating, count blast cells as you should suspect AML-M3 ask for IPT and t(15;17).

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