II. Physiology

  1. Bone Marrow produces lymphocytic progenitor cells
    1. Lymphoblasts form in marrow, divide to Prolymphocytes
    2. Prolymphocytes develop into 2 separate cell lines
      1. B-Lymphocytes develop in Bone Marrow
      2. T-Lymphocytes develop in Thymus
  2. Bone Marrow produces three stem cell myeloid lines
    1. Erythroblasts (Initial cell known as Proerythroblast)
      1. Develop into erythrocytes (Erythropoiesis)
    2. Myeloblasts (Granuloblasts)
      1. Represent 75% of nucleated cells in marrow
      2. Develop into Promyelocyte and then Granulocyte
      3. Characteristics
        1. Evenly distributed fine chromatin
        2. Multiple nucleoli
        3. Basophilic cytoplasm (non-granular)
    3. Megakaryocyte (Megalokaryocyte)
      1. Giant cell with multi-lobulated nucleus in marrow
      2. Releases mature blood platelets from cytoplasm

III. Background

  1. Minimum of 500 cells must be counted
  2. Sample staining
    1. Wright Stain or
    2. May-Grunwald-Giemsa Stain

IV. Normal Bone Marrow Examination Findings

  1. Fat to Cell Ratio
    1. Child under age 10 years: 10% fat to 90% cells
    2. Adult: 30% - 70% fat to 70% - 30% cells
  2. Myeloid to Erythroid ratio: 3 to 1 ratio
  3. Erythroid Cells: 18 to 39% of marrow nucleated cells
  4. Megakaryocytes: 0.5 to 2% of nucleated cells in marrow
  5. Lymphocytes: 11 to 23% of nucleated cells in marrow
    1. T-Lymphocyte to B-Lymphocyte ratio: 3 to 1
  6. Plasma Cells: 0.4 to 3.9% of nucleated cells in marrow
  7. Myeloid Cells: 60-75% of nucleated cells in marrow
    1. Neutrophilic series: 49 to 65%
    2. Eosinophilic series: 1.2 to 5.3%
    3. Basophilic series and mast cells: <0.2%

V. References

  1. Lee (1999) Wintrobe's Hematology, Lippincott, p. 23-25

Images: Related links to external sites (from Google)

Ontology: Bone Marrow (C0005953)

Definition (MSHCZE) Tkáň uvnitř kosti v dřeňové dutině. U člověka je po narození jediným místem krvetvorby (hemopoezy). U malých dětí je krvetvorná (červená) dřeň přítomna ve většině kostí, v dospělosti pak jen v některých (kosti lebky, hrudní kost, pánevní kosti), ostatní se mění na dřeň tukovou (žlutou). Z hrudní kosti lze dřeň odebrat k vyšetření (sternální punkce), z pánevní kosti se odebírá dřeň k transplantaci, kterou se léčí některé těžké krevní choroby (zejm. leukemie). (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI_NCI-GLOSS) The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.
Definition (NCI) The tissue occupying the spaces of bone. It consists of blood vessel sinuses and a network of hematopoietic cells which give rise to the red cells, white cells, and megakaryocytes.
Definition (NCI_CDISC) The tissue occupying the spaces of bone. It consists of blood vessel sinuses and a network of hematopoietic cells which give rise to the red cells, white cells, and megakaryocytes. (NCI)
Definition (MSH) The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells.
Definition (CSP) soft tissue filling the cavities of bones; exists in two types, yellow and red; yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells; red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes; bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells.
Concepts Tissue (T024)
MSH D001853
SnomedCT 279729006, 256888005, 14016003
HL7 BMAR
LNC LP7410-6, LP33671-6, MTHU001324, MTHU016536
English Bone Marrow, Marrow, Bone, All bone marrow (body structure), All bone marrow, Medulla ossea, Medulla ossium, Bone mar, hematopoietic marrow, bone marrow, Bone marrow (body structure), Marrow (bone), BONE MARROW, Bone marrow, BM - Bone marrow, Bone marrow structure (body structure), Bone marrow structure, Haematopoietic marrow, Hematopoietic marrow, Bone marrow, NOS, Reticuloendothelial System, Bone Marrow
Swedish Benmärg
Czech kostní dřeň
Finnish Luuydin
Russian KOSTNYI MOZG, КОСТНЫЙ МОЗГ
Croatian KOŠTANA SRŽ
Latvian Kaulu smadzenes
Polish Szpik kostny czerwony, Szpik kostny, Szpik kostny żółty
Norwegian Beinmarg, Benmarg
Spanish estructura de la médula ósea (estructura corporal), estructura de la médula ósea, médula hematopoyética, médula hemopoyética, médula ósea (estructura corporal), médula ósea, Médula Ósea
French Moelle osseuse
German Knochenmark
Italian Midollo osseo
Dutch Beenmerg
Portuguese Medula Óssea

Ontology: Erythroblasts (C0014762)

Definition (MSH) Immature, nucleated ERYTHROCYTES occupying the stage of ERYTHROPOIESIS that follows formation of ERYTHROID PRECURSOR CELLS and precedes formation of RETICULOCYTES. The normal series is called normoblasts. Cells called MEGALOBLASTS are a pathologic series of erythroblasts.
Definition (NCI) An immature, nucleated erythrocyte occupying the stage of erythropoiesis that follows formation of erythroid progenitor cells and precedes formation of reticulocytes.
Definition (NCI) Red blood cells that are at the last stage of development, still containing a nucleus, that are found in the bone marrow and occasionally in the peripheral blood.
Concepts Cell (T025)
MSH D004900
SnomedCT 84227004, 29208003
LNC LP14464-9, MTHU004246
English Erythroblasts, erythroblast, erythroblasts (lab test), erythroblasts, nucleated erythrocytes (lab test), nucleated erythrocytes, erythrocyte morphology nucleated erythrocytes, Nucleated Red Blood Cell, Nucleated red cells, Erythrocyte, Nucleated, Erythrocytes, Nucleated, Nucleated Erythrocytes, nucleated red blood cells, normoblast, normoblasts, nucleated red cells, Erythrocytes.nucleated, Nucleated Erythrocyte, Erythroblast, NRBC - Nucleated red blood cell present, Nucleated red blood cell, Nucleated erythrocyte, Erythroblast (cell), Nucleated red blood cell (cell), Nucleated red blood cell - observation, Nucleated red cell, Nucleated erythrocyte, NOS, Nucleated red blood cell, NOS, Nucleated red cell, NOS, Nucleated red blood cell (body structure)
Italian Globuli rossi nucleati, Eritrociti nucleati, Eritroblasti
Spanish hematíe nucleado, célula roja nucleada, glóbulo rojo nucleado - observación, eritroblasto (célula), eritroblasto, eritrocito nucleado, glóbulo rojo nucleado (célula), glóbulo rojo nucleado (estructura corporal), glóbulo rojo nucleado, Hematíes nucleados, Eritroblastos, Eritrocitos Nucleados
Dutch erytroblasten, kernhoudende rode bloedcellen, Erythroblast, Erythroblasten, Normoblasten, Erytrocyt, kernhoudende
French Erythroblastes, Érythrocytes nucléés, Érythroblastes, Érythroblaste, Hématies nucléées
Japanese 有核赤血球, ユウカクセッケッキュウ, セキガキュウ, 前赤芽球, 前正赤芽球, 正赤芽球, 赤芽球
Swedish Erytroblaster
Czech erytroblasty, Jaderné erytrocyty, Erytroblasty
Finnish Erytroblastit
Russian ERITROBLASTY, PROERITROBLASTY, PRONORMOBLASTY, NORMOBLAST, НОРМОБЛАСТ, ПРОНОРМОБЛАСТЫ, ПРОЭРИТРОБЛАСТЫ, ЭРИТРОБЛАСТЫ
Latvian Not Translated[Erythroblasts]
Polish Erytroblasty, Normoblasty
Hungarian Eritroblasztok, magvas vörösvértestek
Norwegian Erytrocytter, kjerneholdige, Erytroblaster
Portuguese Eritrócitos nucleados, Eritroblastos, Eritrócitos Nucleados
German kernhaltige Erythrozyten, Erythroblasten, Kernhaltige Erythrozyten

Ontology: Megakaryocytes (C0025166)

Definition (MSHCZE) Buňka kostní dřeně, z níž se tvoří krevní destičky (trombocyty). (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) Very large bone marrow cells which release mature blood platelets.
Definition (MSH) Very large BONE MARROW CELLS which release mature BLOOD PLATELETS.
Definition (CSP) giant cell of bone marrow, a large cell with a greatly lobulated nucleus; mature blood platelets are released from its cytoplasm.
Concepts Cell (T025)
MSH D008533
SnomedCT 259728004, 23592000
English megakaryocyte, Megakaryocytic, megalocaryocyte, megalokaryocyte, megakaryocytes, megacaryocyte, Megakaryocyte (substance), Megakaryocyte, Megakaryocyte (cell), Megakaryocyte, NOS, Megakaryocytes
French Mégacaryocytes, Mégacaryocyte
Swedish Megakaryocyter
Czech megakaryocyty
Finnish Megakaryosyytit
Russian MEGAKARIOTSITY, МЕГАКАРИОЦИТЫ
Croatian MEGAKARIOCITI
Latvian Megakariocīti
Polish Megakariocyty
Norwegian Megakaryocytter
Spanish megacariocito (sustancia), megacariocito (célula), megacariocito, Megacariocitos
German Megakaryozyten
Italian Megacariociti
Dutch Megakaryocyt, Megakaryocyten
Portuguese Megacariócitos

Ontology: Prolymphocyte (cell) (C0229614)

Definition (NCI) A medium-sized round lymphocyte of B or T-cell lineage with prominent nucleoli. It is an intermediate cell between the lymphoblast and the small, mature lymphocyte.
Concepts Cell (T025)
SnomedCT 19394005
LNC LP15082-8, MTHU014313
English Prolymphocyte (cell), prolymphocyte, prolymphocytes, Prolymphocytes, Prolymphocyte
Spanish prolinfocito (célula), prolinfocito