Morphology (Haematological Cytology)

Screening

A morphological screening assessment (modified Wright’s stain) is performed on almost every sample by the HODS duty scientist. Morphological screening alone may provide the diagnosis, and will direct the strategy of further investigations (e.g. choosing relevant flow cytometry and/or FISH panels or molecular tests). This screening can also be useful in assessing the quality of the sample and may indicate any possible limitations that may arise due to cellularity or integrity.

If morphological assessment has not been requested by the submitter, this result will be documented internally by the laboratory, but not formally reported and no charge is incurred. Bone marrow aspirates are reported by a consultant haematologist or haematopathologist, and where appropriate another consultant double-reports the case.

When appropriate, a differential count is performed on peripheral blood and/or bone marrow aspirate slides. Morphological assessment will be undertaken to assess cellularity and the presence of myelodysplasia or other abnormal cells. Iron stain (Perls’ Prussian blue) is performed if indicated.

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Specimens required

• Blood smear (unstained)

• Bone marrow smears x3 and/or squash (unstained)

• Bone marrow aspirate (1-2 mL) in EDTA

• Dab preparations from trephine or solid tissue (lymph node)

• Body fluids e.g. CSF; pleural fluid, in conservation fluid

Sample Storage

• Air-dried, room temperature

Bone marrow aspirate reporting

• The bone marrow aspirate report will provide a description and quantify the different cell populations present in the sample

• Abnormal cell types will be described in detail and myelodysplasia will be quantified per cell line if indicated

• Iron stain (Perls’ Prussian Blue) is performed if indicated

• Blood films should be included with all bone marrow aspirate samples

• An interpretation of the morphological results will be provided, with a reference to the most pertinent pending investigations

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