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===Lamellar bone=== | ===Lamellar bone=== | ||
[[File:Lamella bone H&E and under polarised light.gif|thumb|Animated GIF showing a photomicrograph of lamellar bone. The layers are accentuated under polarised light.]] | |||
*Collagen organized in layers (lamellae). | *Collagen organized in layers (lamellae). | ||
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==Bone marrow== | ==Bone marrow== | ||
{{Main|Haematopoiesis}} | {{Main|Haematopoiesis}} | ||
===General=== | |||
*One of two ''[[primary lymphoid organs]]'' - the other one is the [[thymus]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref> | *One of two ''[[primary lymphoid organs]]'' - the other one is the [[thymus]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref> | ||
Bone marrow biopsy adequacy:<ref name=pmid16477878>{{Cite journal | last1 = Rudzki | first1 = Z. | last2 = Partyła | first2 = T. | last3 = Okoń | first3 = K. | last4 = Stachura | first4 = J. | title = Adequacy of trephine bone marrow biopsies: the doctor and the patient make a difference. | journal = Pol J Pathol | volume = 56 | issue = 4 | pages = 187-95 | month = | year = 2005 | doi = | PMID = 16477878 }}</ref> | |||
*10 intertrabecular spaces or 10 mm. | |||
===Microscopic=== | |||
One should see three cell lines:<ref>URL: [http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]. Accessed on: 28 March 2012.</ref> | |||
#Erythroid (red cells). | |||
#Myeloid (white blood cells). | |||
#Megakaryocytic (platelets). | |||
Adipose tissue: | |||
*Fat content (%) ~= age in years.<ref>IAV. 26 Feb 2009.</ref> | *Fat content (%) ~= age in years.<ref>IAV. 26 Feb 2009.</ref> | ||
**e.g. 60 year old will have 60% fatty replacement. | **e.g. 60 year old will have 60% fatty replacement. | ||
Identifying the cell lines:<ref>[http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png]</ref> | |||
Identifying the lines:<ref>[http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png]</ref> | |||
#Megakaryocytes: | #Megakaryocytes: | ||
#*Big cells ~ 3x the size of a [[RBC]]. | #*Big cells ~ 3x the size of a [[RBC]]. | ||
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#*Reniform nucleus, i.e. kidney bean shaped nucleus. | #*Reniform nucleus, i.e. kidney bean shaped nucleus. | ||
Note: | |||
< | *Lymphocytes are considered separately and typically spared in bone marrow failure.<ref>[http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]</ref> | ||
</ | |||
====Organization==== | ====Organization==== | ||
*Mature hematopoeitic cells at the centre (distant from bone). | *Mature hematopoeitic cells at the centre (distant from bone). | ||
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*Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal | last1 = Iancu | first1 = D. | last2 = Hao | first2 = S. | last3 = Lin | first3 = P. | last4 = Anderson | first4 = SK. | last5 = Jorgensen | first5 = JL. | last6 = McLaughlin | first6 = P. | last7 = Medeiros | first7 = LJ. | title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. | journal = Arch Pathol Lab Med | volume = 131 | issue = 2 | pages = 282-7 | month = Feb | year = 2007 | doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 | PMID = 17284114 }}</ref> | *Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal | last1 = Iancu | first1 = D. | last2 = Hao | first2 = S. | last3 = Lin | first3 = P. | last4 = Anderson | first4 = SK. | last5 = Jorgensen | first5 = JL. | last6 = McLaughlin | first6 = P. | last7 = Medeiros | first7 = LJ. | title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. | journal = Arch Pathol Lab Med | volume = 131 | issue = 2 | pages = 282-7 | month = Feb | year = 2007 | doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 | PMID = 17284114 }}</ref> | ||
**Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)]. | **Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)]. | ||
===Images=== | |||
<gallery> | |||
Image:Bone_marrow_WBC.JPG| Myeloid line. (WC) | |||
</gallery> | |||
===Sign out=== | |||
====Essentially normal==== | |||
<pre> | |||
Bone Marrow, Posterior Superior Iliac Spine, Biopsy: | |||
- Bone marrow with trilineage hematopoiesis. | |||
- Cellularity within normal limits for age. | |||
- Case will be sent to hematology for consultation and correlation | |||
with other testing. | |||
</pre> | |||
====Inadequate==== | |||
<pre> | |||
Right Posterior Superior Iliac Spine, Bone Marrow Biopsy: | |||
- Predominantly benign dense fibrous tissue with a small | |||
amount of laminar bone, and minute fragment of marrow (<2 mm). | |||
- Case will be sent to hematopathology for further assessment. | |||
</pre> | |||
=Benign variants= | =Benign variants= | ||
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- MARROW SPACE WITH FIBROSIS AND SCATTERED LYMPHOCYTES AND PLASMA CELLS, | - MARROW SPACE WITH FIBROSIS AND SCATTERED LYMPHOCYTES AND PLASMA CELLS, | ||
COMPATIBLE WITH MILD CHRONIC OSTEOMYELITIS. | COMPATIBLE WITH MILD CHRONIC OSTEOMYELITIS. | ||
- NO MICROORGANISMS APPARENT WITH ROUTINE STAINS. | |||
- NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR MALIGNANCY. | ||
</pre> | </pre> | ||
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A general DDx for cystic bone lesions is found on ''radipedia.com''.<ref>URL: [http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions]. Accessed on: 15 March 2011.</ref> | A general DDx for cystic bone lesions is found on ''radipedia.com''.<ref>URL: [http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions]. Accessed on: 15 March 2011.</ref> | ||
==Sequestrum== | |||
{{Main|Sequestrum}} | |||
==Osteoarthritis== | ==Osteoarthritis== |
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