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Bone Marrow Aspiration - slide for review

Anemia
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Report in 72Hrs

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No Fasting Required

Details

Cytological review of aspirated bone marrow smear.

₹1,070₹1,529

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Bone Marrow Aspiration - Slide for Review

  • Why is it done?
    • Test Purpose: Bone marrow aspiration obtains a liquid sample of bone marrow cells from the iliac crest or sternum. The aspirated sample is spread on glass slides for microscopic examination to evaluate cell morphology, maturation, and abnormalities.
    • Primary Indications: Diagnosis of hematologic malignancies (leukemias, lymphomas, myelomas); evaluation of unexplained anemia, thrombocytopenia, or leukopenia; assessment of bone marrow failure syndromes; investigation of fever of unknown origin; monitoring therapeutic response in hematologic disorders; staging of lymphomas and other cancers; evaluation of pancytopenia
    • Typical Timing: Performed when peripheral blood smear findings are abnormal or inconclusive; during initial diagnosis of suspected hematologic disease; during treatment follow-up of known blood disorders; when bone marrow biopsy tissue is obtained for concurrent histopathological examination
  • Normal Range
    • Normal Cell Proportions (Differential): Myeloid cells: 60-80%; Erythroid cells: 15-25%; Lymphocytes: 5-15%; Monocytes: 2-8%; Megakaryocytes: 0.1-0.5% (per 100 nucleated cells)
    • Myeloid-to-Erythroid Ratio (M:E): Normal range: 2:1 to 4:1. Indicates balance between white and red blood cell production.
    • Cellularity: Normal marrow is normocellular (50-75% cellularity). Age-adjusted: decreases with advancing age.
    • Maturation Pattern: Orderly progression of cell maturation from blast forms to mature cells. No dysplasia or abnormal morphology. Adequate iron stores.
    • Interpretation of Results: Normal findings indicate normal bone marrow function with adequate hematopoiesis. Abnormal findings may indicate malignancy, infection, aplasia, dysplasia, or metabolic disorders.
  • Interpretation
    • Leukemia Findings: Increased blasts (>20% indicates leukemia); abnormal blast morphology; immature cell predominance; disrupted normal maturation. Classification into acute vs. chronic, type (AML, ALL, CLL, CML) determined by cytochemistry and immunophenotyping.
    • Aplastic Anemia: Hypocellular or acellular marrow (<10% cellularity); reduced myeloid, erythroid, and megakaryocytic elements; lymphocyte relative increase
    • Myelodysplastic Syndrome (MDS): Dysplastic changes in one or more cell lines; abnormal maturation; occasional increased blasts (5-19%); cytopenia despite variable cellularity
    • Hypercellular Marrow: (>75% cellularity) Indicates increased hematopoiesis; seen in response to anemia, chronic hemolysis, polycythemia, chronic infections, or proliferative disorders
    • Iron Stores: Decreased iron suggests iron deficiency; increased iron indicates iron overload or sideroblastic anemia
    • Infection or Infiltration: Granulomas suggest tuberculosis or fungal infection; abnormal cells indicate metastatic disease, lymphoma infiltration, or myeloma
    • Factors Affecting Interpretation: Recent chemotherapy or transfusions; medications; specimen quality and preparation; sampling error; need for concurrent flow cytometry and cytochemistry for accurate diagnosis
  • Associated Organs
    • Primary Organ System: Hematopoietic system; bone marrow residing in flat bones (pelvis, sternum, ribs) and long bone metaphysis
    • Related Conditions - Hematologic: Acute myeloid leukemia (AML); acute lymphoblastic leukemia (ALL); chronic myeloid leukemia (CML); chronic lymphocytic leukemia (CLL); multiple myeloma; lymphomas; polycythemia vera; essential thrombocythemia; primary myelofibrosis; myelodysplastic syndromes; aplastic anemia; hemolytic anemia
    • Related Conditions - Infectious: Tuberculosis; fungal infections; mycobacterial infections; bacterial sepsis; viral infections affecting bone marrow
    • Related Conditions - Systemic: Sarcoidosis; systemic lupus erythematosus; metastatic cancer; lipidosis; metabolic disorders affecting marrow
    • Potential Complications of Abnormal Results: Severe anemia leading to tissue hypoxia; bleeding complications from thrombocytopenia; infections from leukopenia; disease progression of malignancy if not treated; organ dysfunction from infiltration; metabolic complications from bone marrow failure
  • Follow-up Tests
    • Concurrent Testing: Flow cytometry for immunophenotyping; cytochemical stains (MPO, PAS, SBB); bone marrow biopsy for histology; cytogenetics and FISH; molecular testing for gene mutations
    • Complementary Tests: Complete blood count (CBC); peripheral blood smear; coagulation studies; biochemistry panel; lactate dehydrogenase; uric acid; immunoglobulin levels
    • Staging and Further Investigation: Imaging studies (CT, PET-CT) for malignancy staging; spinal fluid examination for CNS involvement; lymph node biopsy; organ function tests
    • Monitoring Frequency: During active treatment: every 4-8 weeks initially; for remission monitoring: every 3-6 months; for aplastic anemia: monthly during treatment, then quarterly; for MDS: every 3 months; for stable chronic conditions: at least annually
    • Treatment Response Monitoring: Post-chemotherapy aspiration to assess for leukemic burden reduction; evaluation of cytopenia recovery; minimal residual disease detection by flow cytometry
  • Fasting Required?
    • Fasting Requirement: NO - Fasting is not required for bone marrow aspiration
    • Pre-Procedure Preparation: Patient may eat and drink normally; light meal or snack is permissible before procedure; maintain normal hydration
    • Medication Management: Continue regular medications unless instructed otherwise; warfarin or antiplatelet agents may need to be held 3-5 days prior (consult with physician); aspirin should be discontinued 5-7 days before procedure
    • General Instructions: Wear comfortable clothing; arrange transportation as procedure involves local anesthesia/conscious sedation; inform provider of allergies, especially to lidocaine or other anesthetics; arrive 15-30 minutes early for registration; bladder may need to be emptied before procedure
    • Post-Procedure: Can eat and drink immediately after procedure; resume all regular medications as prescribed; avoid strenuous activity for 24 hours; keep puncture site clean and dry

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