Maximizing the diagnostic yield from bone marrow aspirate material using the cell block technique on clot sections
Menchu G Ong1, Mary Lowery-Nordberg2, Sudha Pillarisetti3
1Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, LA.
Background:
Paraffin section of bone-marrow aspirate (clot section) is one of several components of bone marrow biopsy. Improper acquisition of aspirate material results in lack of diagnostic tissue and a waste of resources.
Objective:
To detail a novel cell block method of aspirated marrow as a way to ensure maximum yield. This is of particular value when the material gathered via core biopsy is inadequate.
Method:
We used the cell block method to evaluate paraffin-embedded sections of hematopoietic tissue from bone marrow aspirate.
Results:
The range of diagnoses possible from an adequate clot section parallels those from a comparable core biopsy. Examples of an adequate clot section include lesions assessed by routine hematoxylin-eosin (H&E) staining, special and immunohistochemistry (IHC) stains, and molecular diagnostic studies such as fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR).
Conclusion:
A bone marrow clot section comprised of sinusoidal blood is inadequate for morphological interpretation and is a waste of resources. Hence, we recommend the cell block technique for procurement; this method ensures maximum capture of material needed to establish a diagnosis.
