16) Bone marrow & cytochemical stains Flashcards

(68 cards)

1
Q

2 BM compartments

A
  • hematopoietic
  • vascular
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2
Q

contents of the hematopoietic compartment of BM

A
  • hematopoietic cells
  • stroma (support)
  • red & yellow marrow
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3
Q

parts of the vascular compartment of the BM

A
  • nutrient artery
  • veins
  • arterioles
  • sinuses
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4
Q

2 parts of BM that may be collected

A

aspirate
core biopsy

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5
Q

example of needle used for BM

A

Jamshedi

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6
Q

sites for BM collection

A

adult—posterior ileac crest
child <2yo—tibia

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7
Q

not a contraindication for BM collection

A

low platelet
anticoag therapy

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8
Q

aspirate is used for…

A
  • cell morphology, quantity, maturation process
  • cytogenetics
  • flow cytometry
  • molecular studies
  • cultures
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9
Q

crush smear made from aspirate

A

particle smear

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10
Q

push smear made from aspirate

A

direct smear

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11
Q

made by touching core biopsy to slide

A

touch prep

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12
Q

obtained from special needle to take out piece of marrow without distorting its arrangement

A

core biopsy

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13
Q

core biopsy & particle prep used for…

A
  • architecture of BM
  • cellularity of BM
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14
Q

——— are counted on 10x BM aspirate

A

megakaryocytes

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15
Q

RR megakaryocytes

A

5-10 per 10x

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16
Q

how is differential count different for BM?

A
  • 500-1000 cells counted
  • megakaryocytes not counted
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17
Q

if there is no aspirate, use ——– for differential

A

touch prep

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18
Q

up to ——– of BM is lymphs in children <3yo

A

1/3

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19
Q

normal M:E ratio

A

2:1 to 4:1

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20
Q

used for assessing BM cellularity

A

core biopsy

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21
Q

used for assessing BM iron stores

A

aspirate

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22
Q

———-% of erythroblasts have Fe specks (sideroblasts)

A

30-50

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23
Q

BM finding diagnostic for sideroblastic anemia or MDS

A

ringed sideroblast

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24
Q

cytochemical BM stains must be performed on fresh slides because…

A

they stain based on enzyme activity

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25
cytochemical stains are helpful in differentiating ---------------, because there are >20% blasts
acute leukemias
26
ancillary studies for BM
- flow cytometry - cytogenetics - FISH - molecular genetics
27
helpful in detecting minimal residual disease (post-tx)
PCR
28
4 ways to differentiate leukemic blasts
- morphology - surface markers - cytogenetics - cytochemical stains
29
MPO stain positives
**primary granules** - grans (intense) - monos (weak)
30
MPO stain negatives
- lymphs
31
MPO stain used to differentiate...
AML from ALL
32
sudan black positives
**phospholipids** - grans - monos (weakly)
33
sudan black negatives
- lymphs
34
sudan black has the same application as MPO, except...
it can be used with less fresh specimens
35
other names for chloroacetate esterase stain
specific esterase naphthol chloroacetate
36
specific esterase stain positives
- grans - masts
37
specific esterase stain negatives or weak positives
- monos - lymphs
38
specific esterase used to differentiate...
grans from monos
39
other names for alpha-naphthyl esterase stain
nonspecific esterase alpha-naphthyl butyrate
40
nonspecific esterase stain positives
- monos - macros
41
after staining with nonspecific esterase, ------------- will inhibit staining in monos
sodium fluoride
42
nonspecific esterase dot-like positivity in...
- plasma cells - hairy cells - T-cells - megakaryocytes
43
nonspecific esterase stain negatives
- grans - most lymphs
44
nonspecific esterase stain useful in dx of...
myelomonocytic and monocytic leukemia
45
PAS
periodic acid schiff stain
46
PAS stain positives
**glycogen** - erythroblasts (strong) - lymphoblasts (blocklike) - mature grans
47
PAS stain negatives
- young grans - mature lymphs
48
LAP
leukocyte alkaline phosphatase stain
49
LAP stains the...
secondary granules of maturing neutros
50
activated neutrophils contain ---- LAP, and CML neutrophils contain ------ LAP
↑ ↓
51
causes of ↓ LAP
- CML - PNH - ITP
52
normal LAP
13-130
53
how LAP is graded
100 neutros are graded 1+ to 4+ by how much they stain
54
TRAP
tartrate-resistant acid phosphatase
55
T-cell ALL focal positivity
TRAP
56
explain how TRAP is used to distinguish hairy cells from mast cells
1. **acid phosphatase** stains all cells 2. **tartrate** removes stain, except from hairy cells, masts, and some lymphs (weak) 3. **toluidine blue** does not stain hairy cells, and it does stain masts
57
tartrate-resistant
hairy cells masts some lymphs (weakly)
58
TdT
terminal deoxynucleotidyl transferase stain
59
TdT is a...
DNA polymerase found in the nucleus
60
TdT is a primitive cell marker for distinguishing...
ALL from lymphoma
61
TdT positives
almost all T-cell ALLs
62
TdT negatives
lymphomas
63
TdT is NOT useful for...
distinguishing myeloid from lymphoid
64
toluidine blue positives
**mucopolysaccharides** - basos - masts
65
toluidine blue is useful for distinguishing...
masts from hairy cells
66
reticulin
framework fibers of the BM
67
reticulin stain is used to assess...
presence of fibrosis
68
------------ is markedly increased in myelofibrosis
reticulin