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Bone Marrow Sampling and Processing
Abstract
Bone marrow aspirate and biopsy are complementary for proper assessment. Adequate sampling and processing are critical for accurate examination. Technical artifacts may compromise marrow interpretation. The multistep processing of the bone marrow involves various fixation, decalcification, and embedding protocols. Formalin fixation, EDTA decalcification, and paraffin embedding are the most common and the least injurious applied routine methods, allowing the application of many ancillary tests, such as immunohistochemistry (IHC), molecular tests, and in situ hybridization (ISH). Hematologic stains used for routine morphologic examination include the wright-Giemsa stain for bone marrow aspirate smears, hematoxylin and eosin, May Grunwald-Giemsa, and reticulin stain for bone marrow biopsy sections. Quality assurance measures are essential throughout bone marrow preparation to avoid diagnostic errors. Improper specimen collection, inadequate processing, and staining are possible sources of errors.
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