An observation of a potential metastatic mimic in bone marrow aspirate smears

Abstract

We present an interesting observation of crushed erythroid precursors in bone marrow aspirate smears mimicking metastatic deposits. These artefactual clusters could be due to anticoagulation with ethylenediaminetetraacetic and also due to shearing forces exerted on the cells during aspiration and smearing. It is important to be aware of this potential mimic as in a given clinical context it can get misdiagnosed as metastasis.

Distorted normal cells mimicking metastatic deposits in bone marrow aspirate

“…EDTA can induce cell clumping secondary to the presence of cell membrane-bound antibodies. Prolonged storage and high concentrations of EDTA can also cause hyperosmolar effect and bursting of cell membranes 1 2. Technical factors during the preparation of smears can also contribute to the distortion of cells.…”