Pitfalls in bone marrow pathology: avoiding errors in bone marrow trephine biopsy diagnosis

Abstract

Avoiding errors in the histological interpretation of bone marrow trephine biopsy specimens requires an unprecedented degree of collaboration between histopathologists, haematologists, specimen requesters, specimen takers, laboratory technical staff and other scientific staff. A specimen of good quality, with full, relevant clinical information is the essential starting point. This must then be processed optimally and investigated appropriately, involving immunophenotyping and molecular testing when needed. A wide range of pathologies may involve bone marrow haemopoietic and stromal components, and a systematic approach to analysing each of the components in turn is required to avoid overlooking abnormalities; correlation with bone marrow cells aspirated in parallel is particularly important. Final interpretation should be a synthesis of the histological findings with information from such haematological and other investigations, interpreted with due regard to clinical context.

Bone Marrow Aspiration in North Sudan : The Procedure , Indications and the Diagnostic Value

“…(11) The need for collaboration between all stakeholders: physicians, hematologists, pathologists, oncologists and technicians are very important in improving the diagnostic yield of bone marrow examination. (12) Limitations of our study include the small sample size that may not allow generalization. Despite this limitation, however, this study is novel and is the first of its kind in north Sudan and is anticipated to constitute a database for future studies.…”

ICSH guidelines for the standardization of bone marrow immunohistochemistry

“…If the BM sample does not contain the lesion, no special studies could compensate for the deficiency of proper sampling . Therefore, general guidelines for BM biopsy should be followed in the first place . Recommendation 3 . It is recommended that the interpretation starts with the evaluation of the external control(s), by which it is determined that the proper antibody was applied and the test is properly calibrated. Recommendation 4 .…”

Normales Knochenmark und häufige reaktive Veränderungen

“…B. tangentiale Entnahme mit reichlich miterfasster Kortikalis) und ausreichend Markräume zur Beurteilung vorliegen hat. Zumindest drei intakte intertrabekuläre Markraumareale sollten zur Beurteilung vorliegen [40]. …”