STRUCTURE OF BONE MARROW

AZIZAH

HALEEM

PBL

Bone marrow is a highly cellular structure present within the hollow cavities of hard bone tissue

There is 2 types of bone marrow:

A)red bone marrow B)yellow bone marrow

WHAT IS BONE MARROW??

Children:bone marrow in all bones is red bone marrow

Adulthood:bone marrow cells in long bones of hand and leg become non-functional and are replaced by fat cells to form yellow bone marrow.

the only bones to carry red bone marrow throughout life are the vertebrae,sternum, hip bone, and skull bones

constitutes 4% of the total body mass of human

Bone marrow cells are highly functional and continuously divide and give rise to the different cells present in blood.

changes in bone marrow cause change in the composition of blood which can lead to various diseases

connective tissue cells of any organ cells that support the function of

the parenchymal cells of that organ It is indirectly involved in hematopoiesis- release colony stimulating factor provides the hematopoietic microenvironment

that facilitates hematopoiesis by the parenchymal cells

Cells that constitute the bone marrow stroma are:

fibroblasts (reticular connective tissue) macrophages adipocytes osteoblasts osteoclasts endothelial cells, form the sinusoids.

Stroma

Aplastic anemiaMalignancies- multiple myeloma Infections- tuberculosisvarious forms of leukemia

Diseases of the bone marrow

Development,morphology and function of plasma cell

Plasma cells arise from stem cells in the bone marrow

Plasma cells develop from B lymphocytes(known as B cells) cells when foreign substances (antigens), such as bacteria

antigen is taken up by the B cell through receptor-mediated endocytosis and processed

Development of plasma cell

Pieces of the pathogen (antigenic peptides) are loaded onto MHC II molecules, and presented on its extracellular surface to CD4+ T cells (T helper cells).

These cause activation of the B cellUpon stimulation by a T cell, which usually

occurs in germinal centers of secondary lymphoid organs like the spleen and lymph nodes, the activated B cell begins to differentiate into more specialized cells

Germinal center B cells may differentiate into memory B cells or plasma cells

• plasma cell nuclei stain bluish-purple,

• Cytoplasm stain purplish-pink • large irregular eccentric

nuclei, with prominent nucleoli close to the center of the cell

• transparent-like, clear cytoplasm which stained and lost its' transparency in areas distant to the nucleus, where the Golgi apparatus, endoplasmic reticulum and the abundant mitochondria

Morphology of plasma cells

plasma cells produce antibodiesgive out humoral antibodies to curb down the

actions by the antigensBoth of this gives an important role in the

defence mechanism in the body

Function of plasma cells

Bone marrow aspiration &

biopsy indication

A bone marrow biopsy is the removal of soft tissue called marrow from inside bone. Bone marrow is found in the hollow part of most bones. It helps form blood cells.

The biopsy is done using a small needle inserted into an age appropriate area (long bone for children, flat bone for adults).

BONE MARROW BIOPSY

Procedure of bone marrow biopsy:

a) doctor will give you a sedative medication to make you drowsy and relaxed

b) doctor will clean and numb the biopsy site with an anesthetic.

c) A biopsy needle will be insert into the bone to withdraw a sample of bone marrow.

d) The bone marrow sample will be sent to the laboratory for evaluation.

e) Lastly,doctor will remove the needle and clean and bandage the area.

Bone marrow aspiration is the removal of a small amount of this tissue in liquid form for examination.

carried out principally to permit cytological assessment but also for immunophenotypic, cytogenetic, molecular genetic, and other specialised investigations.

Bone marrow aspiration

Skin is numbed and needle is inserted into the bone.

Syringe is used to withdraw the liquid bone marrow.

Needle is removed.

Procedure of bone marrow aspiration

Bone marrow aspiration removes a small amount of bone marrow fluid and cells through a needle that was inserted into the bone.

The bone marrow fluid and cells are checked for problems with any of the blood cells made in the bone marrow. Cells can be checked for chromosome problems. Cultures can also be done to look for infection.

A bone marrow biopsy removes bone with the marrow inside to look under a microscope. The aspiration (taking fluid) is usually done first, and then the biopsy.

Differences between the two tests;

The bone marrow biopsy and aspiration procedure provides information about the status and capability for blood cell production.

Conditions that affect the marrow can affect the number, mixture, and maturity of the cells, and can affect its fibrous structure.

Bone marrow biopsy and aspiration

cultured for the presence of microorganisms such as fungi, bacteria, or mycobacteria.

A bone marrow aspiration and/or biopsy may be ordered as a diagnostic procedure when

Aplastic AnemiaAcute LeukemiaMyelodysplastic SyndromeChronic Myelogenous LeukemiaMyelofibrosis and Essential ThrombocythemiaMultiple Myeloma(our case)Severe thrombocytopenia, anemia and

neutropenia

Bone marrow aspiration and biopsy diagnose?

some patients may have excessive bleeding at the collection site or develop an infection

persistent or spreading redness or bleeding at the site

FeverIncreasing pain.Long-lasting discomfort at the biopsy sitePenetration of the breastbone (sternum) during

sternal aspirations, which can cause heart or lung problems

Complications related to sedation, such as an allergic reaction, nausea or irregular heartbeats

Complication in bone marrow biopsy and aspiration

Normal: Abnormal:

The marrow has normal amounts of fat, connective tissue, and iron. Normal numbers of both mature and immature (growing) bone marrow cells are present

The cells in the bone marrow do not look normal

No signs of infection are seen Signs of infection are seen in the bone marrow.

No cancer cells, such as leukemia, lymphoma, or multiple myeloma, are seen.

Cancer cells, such as leukemia, lymphoma, or multiple myeloma, are seen

No cancer cells have spread from other cancer sites, such as breast cancer.

Too much iron or too little iron (iron deficiency anemia) is seen in the bone marrow.

The bone marrow has been replaced by scar tissue

There are too many or too few bone marrow cells. The bone tissue does not look normal

Bone marrow biopsy and aspiration

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