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Bone Marrow Aspiration and Biopsy

See Specimen Submission Instructions for test requisition, specimen labeling and specimen packaging requirements.

Bone Marrow Procedure

Ideally, bone marrows specimens should include:

    • 8 aspirate slide smears
    • 4 touch prep slides
    • 2 peripheral blood smears

Clot Procedure:

    1. Allow the aspirate to clot in the aspirating syringe for 10-15 minutes at room temperature.
    2. Remove plunger from syringe. Using a wooden applicator stick, gently dislodge clot and place into container of ten percent formalin. Record the time the clot is placed on formalin. Volume of fixative must be ten times that of the specimen.

Core Biopsy Procedure:

    1. Prepare four touch preps. Touch the core specimen to four glass slides and air dry.
    2. Place core specimen into ten percent formalin. Volume of fixative must be ten times that of the specimen.  Mark container with patient data and collection time. Fix core specimens at room temperature.

Additional Information      

    • Chromosomal studies are performed by Regional Pathology Services (UNMC). Include a copy of the CBC results.
    • Place formalin container(s) in one biohazard bag and the slides in another biohazard bag or slide tray. DO NOT place formalin container and slides in the same biohazard bag. Doing so will cause a staining artifact, rendering the smears unreadable.

Aspirate Smears

8-12 aspirate smears should be made the same day as the marrow is drawn using the aspirate. To make smears pre-label the slides using an ML black lab marker or No. 2 lead pencil. Mix the tube of aspirate, put a small amount in a weigh boat from the tube. Using a disposable pipette drop aspirate from the weigh boat onto a slide that is propped up at an angle so the droplet starts to run down the slide, take another slide and lay the bottom edge on the angled slide holding the blood and spicules. Collect a small amount of the blood onto the bottom edge of the slide by moving the slide over the blood and spicules. Take the edge of the slide and place it on the upper ¼ of the pre labeled slide. Slide it up a little towards the top of the slide and pull down quickly at a slight angle. Do not lay the slides on top of one another. Continue this process until you have the required 8-12 slides. Place slides in a 20 slot cardboard slide folder, (do not close). Allow the slides to dry for 10-15 min. The slides are then ready to be taken to the special stains area.

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