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RBC

The document outlines the processes involved in bone marrow biopsy processing, including fixation, decalcification, and paraffin embedding. It discusses various conditions related to dry tap and the Reticulocyte Production Index (RPI) as a measure of bone marrow response to anemia. Additionally, it covers methods for counting reticulocytes and the clinical significance of erythrocyte sedimentation rate (ESR) in various medical conditions.

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19 views37 pages

RBC

The document outlines the processes involved in bone marrow biopsy processing, including fixation, decalcification, and paraffin embedding. It discusses various conditions related to dry tap and the Reticulocyte Production Index (RPI) as a measure of bone marrow response to anemia. Additionally, it covers methods for counting reticulocytes and the clinical significance of erythrocyte sedimentation rate (ESR) in various medical conditions.

Uploaded by

mnn5dyzkmz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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RBC

Salah And Klima Needle


Bone Marrow Biopsy Processing

Fixation

Decalcification

Tissue Processor

Paraffin Embedding

Sections Cut
Dry Tap
● Aplastic Anemia

● Myelofibrosis

● Hcl

● Aml M7

● Myelophthisic Anemia
Pronormoblast

Early normoblast

Intermediate normoblast

Late normoblast

Reticulocyte

Erythrocyte
● RPI= CRC

Maturation time in peripheral blood

Maturation Time Hematocrit

1 day 45

1.5 day 35

2 day 24

3 day 15
● The Reticulocyte Production Index (RPI)

● The RPI can be used to indicate whether the marrow is


successfully responding to the anemia: RPI >3: Good marrow
response (hyperproliferative)

● RPI <2: Inadequate response (hypoproliferative)

● RPI>2 but <3: Appropriate for mild anemia (hemoglobin >10-11

● g/dL) but borderline for more severe anemia


Miller Disc Method Of Counting
● The miller disc may be placed in one of the ocular lenses to
aid in the counting of the reticulocytes.
Wintrobe Westergren

Bore 3mm 2.5 mm

Graduation Up to 100mm Up to 200mm

Anticoagulant Double oxalate 3.8% sodium citrate

Amount of blood 1ml 2.4ml


● Stage of rouleaux formation/aggregation- 10 min

● Stage of sedimentation/settling-40 min

● Stage of packing- 10min


Clinical significance
Increased ESR

• Pregnancy . Anemia

• Macrocytosis

• Inflammatory disease Acute and chronic infection

Multiple myeloma Rheumatic fever

Rheumatoid arthritis

• Anemia

. Tuberculosis Systemic lupus erythematosus


Clinical significance
Decreased ESR

• Hyperviscosity

• Decreased fibrinogen levels

• Polycythemia

• Sickle cell anemia

• Spherocytosis

Microcytosis
MCV(fl) = PCV X 10
RBC

MCH(pg) = Hb X 10
RBC

MCHC(%) = Hb(100mg blood) X 100


PCV
Peripheral Smear Analysis
Clinical Vignettes
MCQ
A 43-year-old Caucasian female complaining of reduced energy
and fatigue is found to have hypochromic, microcytic anemia. Her
past medical history is significant for stable angina treated with
metoprolol and aspirin. Iron supplementation is prescribed. Several
weeks later, a peripheral blood smear demonstrates numerous
enlarged red blood cells that appear blue on Wright-Giemsa stain.
The bluish color of these red blood cells is best explained by the
presence of which of the following?

A. Hemoglobin precipitates
B. Nuclear membranes
C. Ribosomal RNA
D. Histones
Thank you

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