Extensive amyloid deposits in bone marrow aspirate smears

Area of Science:

• Hematology
• Pathology
• Medical Diagnostics

Background:

• Amyloid light-chain (AL) amyloidosis is the most prevalent systemic amyloidosis.
• It frequently results in progressive organ dysfunction and mortality, with cardiac involvement being a primary cause of death.

Purpose of the Study:

• To highlight the diagnostic potential of bone marrow aspirate smears in AL amyloidosis.
• To emphasize the characteristic morphological and optical properties of amyloid deposits in marrow.

Main Methods:

• Examination of bone marrow aspirate smears for amorphous, purplish-blue deposits.
• Polarized light microscopy to assess for congophilic property and apple-green birefringence.

Main Results:

• Amyloid deposits can present as extensive amorphous material in marrow aspirates.
• These deposits exhibit characteristic congophilia and apple-green birefringence under polarized light.

Conclusions:

• Bone marrow aspirate smears are a valuable tool for the rapid diagnosis of AL amyloidosis.
• Specific staining and polarized light microscopy of marrow aspirates can confirm the presence of amyloid.