SAMPLE #1:
A bone marrow aspirate and biopsy were performed to further stage recurrent lymphoma.
The marrow aspirate was performed without complications and a good sample was obtained. It was also sent for flow cytometry and cytogenetic studies, as well as a clot section.
The marrow biopsy was performed in the standard fashion without complications. A good sample was obtained. This was sent to Pathology.
The patient tolerated the procedure well without complications. This is normocellular marrow.
The M:E ratio was somewhat reduced at 2:1.
Granulopoiesis: Normoblastic without maturation arrest.
Erythropoiesis: Normoblastic without maturation arrest.
Megakaryocytes: Normal in number and appearance.
Lymphocytes: Appear somewhat increased, while not atypical, obtained about 25% on a 200 cell differential.
Plasma Cells: Normal in number and appearance.
Abnormal Cells: See above.
Iron Stain: Not performed.
IMPRESSION: This bone marrow demonstrates a decrease in the M:E ratio as well as, we think, an increase in the lymphocytes. However, the lymphocytes do not appear mature and are not large. The marrow biopsy and flow cytometry studies should be helpful in excluding recurrent lymphoma.
SAMPLE #2
The bone marrow aspirate was obtained from the right posterior iliac crest in the usual fashion. The marrow aspirate appeared very dilute. No specific flecks were appreciated, and there was no meaningful material on the bone marrow aspirate slide for interpretation.
A marrow aspirate for flow cytometry and a bone marrow biopsy were obtained at the same time, and results from that will follow.
SAMPLE #3
The bone marrow aspirate was obtained from the right posterior iliac crest in the usual fashion. The marrow was hypocellular with a few flecks obtained. The flecks that were seen were markedly hypocellular. Scattered bone marrow elements were noted.
The patient has megaloblastic red cells, dyspoietic granulocytes with binucleate and mitotic forms. Megakaryocytes were not identified. It is hard to make a major conclusion based on the hypocellularity of the few flecks that were obtained.
Our concern is that he is developing a myelodysplastic disorder. A marrow biopsy will be done in order to look at bone marrow architecture. Cytogenetics sent.
