الفهرس 
Introduction
Bone marrow biopsy techniqueOnly 14 pages are availabe for public view
 |  | from | 163 |  |  |
| | | from | 163 | | |
Abstract
Inspection of the bone marrow is considered one of the most valuable diagnostic tools to evaluate hematologic and non hematological disorders.
The correct reporting of bone marrow trephine specimens requires integration of a wide range of clinical, laboratory and imaging information; histology should not be assessed in isolation. Key components of this integrated approach interpretation are:
– A trephine core of adequate size with minimal disruption by trauma caused during collection.
– Access to detailed background clinical information and results of additional tests (in particular, peripheral blood cell counts, blood and bone marrow aspirate cytomorphology, flow cytometry, cytogenetic analysis and radiological imaging).
– Systematic assessment of all components of the tissue, including trabecular bone and interstitial stroma.
– Awareness of pathologies that may be ‘invisible’ in trephine specimens without immunostaining.
– Use of preselected antibody panels for immunostaining and familiarity with the expected results, including controls.
– Experience in interpreting additional molecular studies, such as clonality PCR and fluorescence in-situ hybridisation, in the particular context of decalcified tissue.
– Familiarity with the major patterns of bone marrow involvement by reactive and neoplastic conditions and their differential diagnosis
– A collaborative approach to working with diverse clinical and laboratory colleagues, plus excellent report-writing skills
– With the rapid pace of development of sophisticated molecular techniques and their application to paraffin-embedded tissues, one can expect that more of these methods will also be used on BM trephines. These include high-throughput screening techniques such as array CGH and perhaps gene expression profiling, as well as improvement in situ techniques, such as immunohistochemistry, interphase FISH and FICTION. The rapid development in the identification of specific genetic alterations in haematopoietic neoplasms, and the development of targeted therapies will further increase the need for molecular and related studies on BM trephine biopsies.