Bone Marrow
Bone marrow aspiration biopsy is used routinely in many pediatric tumors to:
- Diagnose disease
- Stage disease accurately - detects tumor cell deposits in bone marrow
For example:
Metastatic tumor: The bone marrow aspirate below shows heavy infiltration by metastatic neuroblastoma. There are numerous cohesive tumour clumps as well as single tumour cells. Residual hematopoiesis is present but reduced.
Acute Lymphoblastic Leukemia:
Bone marrow analysis looks at :
- Morphology - the size and shape of cells (nucleus and cytoplasm) determine which "FAB" type of the acute lymphoblastic leukemia.
- Cytochemistry (different staining reactions determine type of ALL)
- Immunophenotyping ( B-cell lineage or T-cell lineage lymphoblasts)
- Cytogenetics
