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Bone Marrow Morphology: Normal and Abnormal Findings
Bone Marrow Morphology: Normal and Abnormal Findings
MORPHOLOGY
NORMAL AND ABNORMAL
FINDINGS
Bone marrow biopsy
H&E stain
Normal cellularity
Megakaryocyte Fat
Normal BM aspirate
Erythroid precursors
Myeloid precursors
Blue cytoplasm
Grnaular chromatin
Condensed chromatin
Myeloid series
Normal BMA ( Myeloid series )
Pronormoblast
Myelocyte
Segmented
neutrophil
Band cell
Metamyelocyte
Promyelocyte
Myeloblast
Band cell
Normal myeloblast
Nucleoli
Normal BMA (Plasma cell)
Plasma cell
10-20 u
Segmented neutrophil
Promyelocyte
Metamyelocytes
Myeloid precursors
Metamyelocytes
Band cell
Normal eosinophilic myelocyte
Basophilic myelocyte
Mast cell
Heavily basophilic
cytoplasm Cytoplasmic vacules
Nucleus : spared of
granules
BM macrophage
Nucleus: elongated,
spongy, purple
Engulfed debris
Megakaryocyte ( with engulfed RBC &
neutrophil )
Multilobular nucleus
Erythroid hyperplasia
Red cell aplasia
Hypoplastic marrow ( aspirate )
Aplastic anemia ( BM biopsy )
Cytoplasm: Deeply
basophilic, vacules
Megaloblastic anemia
Giant metamyelocytes
Open chromatin
Polychromatophilic
megaloblasts with
nuclear cytoplasmic
development
dissociation
↑ Megakaryocytes ( ITP )
Iron stores in BM
Normal Absent
Toxic granulations
Chediak-Higashi Syndrome
Hemophagocytosis
ALL-L1
-Uniform appearance
-Moderate rim of basophilic cytoplasm
-Single prominent nucleolus
AML-M2
Auer rod
-Abundant azurophilic
granules
-Some Auer rods
AML-M3 ( APL - Hypergranular)
Abnormal promyelocyte with
heavily azurophilic granulation
Faggot cell
(Auer rods)
AML-M3 (APL-microgranular variant)
Faggot
Microgranular promyeloblast cell
AML-M4 (Acute Myelomonocytic
Leukemia)
Myeloblasts
Monocytoblast
AML-M4 Eo ( Myelomonocytic leukemia
with eosinophilia ) [ inv 16]
Myeloblasts
Normal
eosinophils
Monocytoblast
AML-M5 ( Monocytic Leukemia )
AML-M6 ( Erythroleukemia )
Erythroblasts
AML-M7 (Megakaryoblastic Leukemia)
Various sized blasts
Cytoplasm : abundant-rim around nucleus
Cytoplasmic blebs
Metastatic Neuroblastoma
( Rosette formation )
Reed-Sternberg cell (Hodgkin disease)
Binuclated nucleus
Prominent nucleoli
Cytoplasmic
vaculations
Gaucher cell
Cytoplasm: pale, filled with fibrillar lipid (wrinkled tissue paper appearance)
Nucleus: small, round, eccentric
Cystinosis Niemann-Pick
Disease
Nucleus: small,
round, eccenteric
Sphingomyelin
droplets
Leishmania donovani bodies
Osteoblasts
Cells found in clumps
Spindle-shape cells
Nucleus: single, oval, eccenteric
Nucleoli: 1-3 , light-blue
Osteoclast
Large cell with multiple nuclei(not connected)
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