The Role of Megakaryocyte Assessment in Bone Marrow Cytology

Despite the progress made in recent years in hematological diagnostics, cytological assessment of bone marrow, including the assessment of megakaryocytes, is still an important element of the diagnostic process. It is one of the most accurate methods for detecting even minor abnormalities, which is often superior to histopathological examination in this respect. Although, according to current recommendations, megakaryocytes are not included in the total percentage formula of the myelogram, the assessment of platelet function, morphological features, and quantitative disorders allows for the direction of further diagnostic process. In this article, we present the principles of assessing megakaryocytes in a bone marrow aspirate smear. We also characterize normal megakaryocytes at various stages of megakaryopoiesis, atypical megakaryocytes in pathological and physiological conditions, and cells with a similar morphology to megakaryocytes.