This document discusses techniques used in hematological labs, including examination of blood and bone marrow, flow cytometry, and cytogenetics. It focuses on examination of blood and bone marrow, describing how careful assessment of blood elements can provide diagnostic information. Cellular morphology, quantification of components, and evaluation of parameters from automated cell counters are used to analyze blood. Bone marrow examination can reveal involvement by myeloproliferative neoplasms or lymphoproloferative disorders through analysis of cellularity, clusters of cells, and fibrosis levels.

1. AN INTRODUCTION TO DIFFERENT TECHNIQUES IN
HEMATOLOGICAL LAB

2. • Examination of the Blood and Bone Marrow
• Flow Cytometry.
• Cytogenetics

3. Examination of the Blood and Bone Marrow
• Careful assessment of the blood elements is often the first step in assessment of
hematologic function and diagnosis.
• Many hematologic disorders are defined by specific results of blood tests.
• Examination of blood smears and hematologic parameters often yields
important diagnostic information and allows broad differential diagnostic
impressions to be formed, directing additional specific testing.
• Cellular morphology, in concert with quantification of the blood cellular
components and evaluation of a variety of parameters relating to cellular size
and shape, is required.

5. PRINCIPLES OF AUTOMATED CELL COUNTERS
• Impedance (conductivity) system
• Optical system (Light Scattering)
• Flow cytometry

8. Peripheral smear

12. BM trephine biopsy section showing normal bone structure
; there are anastomosing bony trabeculae.

13. Appearance of erythroblasts in an erythroid island

14. Megakaryocytes

16. Bone Marrow Examination

17. Erythroid hyperplasia

18. Hypocellular Bone Marrow

19. • Bone marrow involvement by :
• Myeloproliferative neoplasm
• Lymphoproloferative disorders.

20. Myeloproliferative Neoplasm
• Chronic myelogenous leukaemia, Philadelphia
chromosome positive (t(9;22)(q34;q11), BCR/ABL)
• Chronic neutrophilic leukaemia
• Chronic eosinophilic leukaemia/hypereosinophilic
syndrome
• Chronic idiopathic myelofibrosis
• Polycythaemia vera
• Essential thrombocythaemia
• Myeloproliferative disorders, unclassifiable

21. BM trephine biopsy section, CGL, showing a packed
marrow with marked granulocytic hyperplasia

22. BM aspirate, Ph-positive CGL, showing hyperplasia of all
granulocytic lineages and a clump of megakaryocytes with
hypolobulated nuclei.

23. BM trephine biopsy section, ET, showing mild hypercellularity with a marked
increase in megakaryocytes which are forming large clusters

24. BM trephine biopsy section, ET, showing clustering of megakaryocytes.
The megakaryocytes are mainly large and hyperlobulated,

25. BM trephine biopsy section, idiopathic myelofibrosis
(cellular phase), showing marked hypercellularity, with an increase
in cells of all three haemopoietic cell lineages,

26. BM trephine biopsy section, idiopathic myelofibrosis
(cellular phase), showing a cluster of megakaryocytes with hyperlobulated nuclei.

27. BM trephine biopsy section, idiopathic myelofibrosis
(cellular phase), showing grade 3 reticulin deposition

28. BM trephine biopsy section, PRV, showing
hypercellularity, erythroid hyperplasia and a cluster of
immature megakaryocytes.

29. LYMPHOPROLIFERATIVE DISORDERS

30. Patterns of bone marrow infiltration observed in
lymphoproliferative disorders

33. Metastatic Breast Carcinoma

34. Metastatic Prostatic Carcinoma