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Old Mon Aug 26, 2013, 06:07 PM
Friedbrain Friedbrain is offline
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Join Date: Aug 2012
Posts: 18
Report says.....?

I received a copy of the "Final Report" (tho it says that cytogenetics are still pending). I have No Clue what any of it means, though. Probably absolutely nothing, just like the doc said.

a) peripheral blood: "mild red blood cell macrocytosis without anemia" (just a petpeeve, but as a scientist, I gotta call out Bad Science when I see it, and this was just AWFUL "science". The data used for this was NOT on the day of the bmb....he didn't draw a CBC for correlation...... AND it was taken on a day when I was sick, so my neutrophils were increased only time, other than an ER visit for inflammation, in 1.5 ys that neutrophils haven't been decreased)
b)bmp and aspirate:
1) "Apparently hypocellular bone marrow with trilineage hematopoiesis (see comment)"
2) "bone marrow biopsy and aspirate are suboptimal for interpretation"

"Comment: morphologic review demonstrates a bone marrow biopsy that is predominantly subcortical with prominent aspiration artifact and marrow dropout, which is approximately 30% cellular with trilineage hematopoiesis. The marrow aspirate smears are aspicular, hemodilute, and inadequate for interpretation. Blasts do not appear increased, as confirmed by flow cytometric immunophenotypic studies"

Gross description states: "Received are an aspirate (part 1), biopsy, flow cytometry, and cytogenetics. Many dilute aspirate slides submitted for processing. Part 2, bone marrow biopsy, is received in B+ fixative labeled with the patient's name. It consists of a single core of tan cancellous bone measuring .8 x .3cm with an unattached piece of brown friable clot measuring .6 x .3cm. The specimen is completely submitted to histology for decalcification in block A"

Fwiw (cuz I don't understand it), Flow Cytometry on the bm says: many granulocytes, less than 1% CD34-positive blasts, approximately 2% CD14-posotive monocytes, a moderate number of heterogeneous T-cells, a few natural killer cells, and very few polytypic B-cells"

Me again, with questions.
1) shouldn't they have done a CBC on the morning of the bmb? The report also notes "peripheral blood smear was not available for review", which I'm guessing means no one has looked at it, and it wasn't available as part of a routine bmb because of this.
2) I had my bmb done at the hospital, with all sorts of equipment and an entire team of people swarming around. Shouldn't someone have looked at the bmb Right THEN under a microscope to make sure it was a good sample before cleaning me up. ???
3) They did immunohistochemical probing and staining on the sample, but then note that because the sample had been decalcified prior to this step, it increased the possibility of false negatives.....so, um, why?
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