Bone Marrow Pathology E-Book

Barbara J. Bain

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1733

Veröffentlichungsjahr: 2024

Beschreibung

Discover a comprehensive and up-to-date reference resource for bone marrow pathology, complete with an extensive list of references

The diagnosis and treatment of bone marrow pathologies is one of the most critical areas of medical research and care. For years, Bone Marrow Pathology has served as the essential reference and teaching tool in the field of haematology, with an authoritative treatment of the subject written by acknowledged leaders in the field. Now fully updated to reflect urgent new changes to the theory and practice of haematology, it promises to serve a new generation of practitioners.

In the book, the characteristics and function of normal bone marrow are extensively discussed. Bone marrow pathology, including both aspirate films and trephine biopsy sections, is examined in a clinical context. The content is augmented by discussion of the peripheral blood findings and supplementary bone marrow tests. Readers of the sixth edition of Bone Marrow Pathology will also find:

• Lavish illustrations with high-quality images of bone marrow and other associated images
• Incorporation of new classifications including the WHO and International Consensus classifications, as well as new and expanded research areas
• Emphasis on practical tools including differential diagnosis and common problems and pitfalls
• A practical, integrated approach to diagnosis

Perfect for trainee and consultant haematologists and haematopathologists, Bone Marrow Pathology will also prove itself invaluable for cytogeneticists, molecular geneticists and anyone working in immunophenotyping.

Leseprobe

Table of Contents

COVER

TABLE OF CONTENTS

DEDICATION PAGE

TITLE PAGE

COPYRIGHT PAGE

PREFACE TO THE SIXTH EDITION

ACKNOWLEDGEMENTS

ABBREVIATIONS

ONE THE NORMAL BONE MARROW: EXAMINING AND REPORTING BONE MARROW SPECIMENS

The distribution of haemopoietic marrow

The organization of the bone marrow

Cellularity

Haemopoietic and mesenchymal cells

Lymphopoiesis

Storage and erythroblast iron

The cellular composition of bone marrow

Interpretation of bone marrow aspirates and trephine biopsies

Artefacts

References

TWO SPECIAL TECHNIQUES APPLICABLE TO BONE MARROW DIAGNOSIS

Cytochemical and histochemical stains

Immunophenotyping

Cytogenetic analysis

Molecular genetic analysis

Ultrastructural examination

Bone marrow culture for assessment of haemopoietic progenitor cell numbers

Bone marrow culture for microorganisms

References

THREE INFECTION AND REACTIVE CHANGES

Infection

Bone marrow granulomas

Reactive lymphoid infiltrates

Plasmacytosis and cytological abnormalities in plasma cells

Mast cells

Histiocytosis

Haemophagocytic syndromes

Iron overload

HIV infection and the acquired immune deficiency syndrome

Blood vessels and vascular lesions

Bone marrow necrosis

Gelatinous transformation

Amyloid deposition

Bone marrow fibrosis

References

FOUR ACUTE MYELOID LEUKAEMIA, MIXED PHENOTYPE ACUTE LEUKAEMIA, THE MYELODYSPLASTIC NEOPLASMS/SYNDROMES AND HISTIOCYTIC AND DENDRITIC CELL NEOPLASMS

Acute myeloid leukaemia

Acute leukaemia of mixed or ambiguous lineage

The myelodysplastic neoplasms/syndromes

The WHO and International Consensus classifications of the myelodysplastic syndromes

Problems and pitfalls in the diagnosis of myelodysplastic syndromes

Clonal cytopenia of undetermined significance and idiopathic cytopenia of unknown significance

Histiocytic and dendritic cell neoplasms

References

FIVE MYELOPROLIFERATIVE AND MYELODYSPLASTIC/MYELOPROLIFERATIVE NEOPLASMS AND RELATED CONDITIONS

Myeloproliferative neoplasms

Myelodysplastic/myeloproliferative neoplasms

References

SIX LYMPHOPROLIFERATIVE DISORDERS

Bone marrow infiltration in lymphoproliferative disorders

B‐lineage lymphomas and leukaemias

Lymphoproliferative disorders of T lineage and natural killer (NK) lineage

References

SEVEN PLASMA CELL NEOPLASMS AND RELATED CONDITIONS

Plasma cell neoplasm

Lymphoplasmacytic neoplasms

Other syndromes associated with secretion of a paraprotein

References

EIGHT DISORDERS OF ERYTHROPOIESIS, GRANULOPOIESIS AND THROMBOPOIESIS

Disorders of red cells

Disorders of leucocytes

Disorders of platelets

References

NINE MISCELLANEOUS DISORDERS

Non‐metastatic effects of cancer

Bone marrow dysplasia with polyclonal haemopoiesis

The bone marrow in connective tissue and autoimmune disorders

Congenital immune deficiency syndromes

Autoimmune lymphoproliferative syndrome

The haematological effects of anti‐cancer and immunosuppressive chemotherapy

The haematological effects of other drugs and chemicals

The effect of irradiation on the bone marrow

The haematological effects of alcohol

Aplastic anaemia

Other causes of bone marrow aplasia and hypoplasia

Pearson syndrome and other mitochondrial cytopathies

Other constitutional abnormalities associated with abnormal haemopoiesis

Paroxysmal nocturnal haemoglobinuria

Bone marrow and other haemopoietic stem cell transplantation

Graft‐versus‐host disease (including the effects of donor‐lymphocyte infusion)

The effects of haemopoietic growth factors and other cytokines

Protein‐calorie malnutrition and calorie deficiency

Storage diseases and storage cells in the bone marrow

Sinus histiocytosis with massive lymphadenopathy (Rosai–Dorfman disease)

Gout

Deposition of foreign substances

Vascular and intravascular lesions [184,255]

References

TEN METASTATIC AND NON‐HAEMOPOIETIC TUMOURS

Haematological, histopathological and genetic features of metastatic tumours

The role of bone marrow examination in the staging of solid tumours

The role of bone marrow examination in identifying the tissue of origin of metastases and markers of relevance to prognosis or treatment

Problems and pitfalls in identification of tumour infiltration of bone marrow

References

ELEVEN DISEASES OF BONE

Problems and pitfalls in assessment of bone

References

APPENDIX

Technical methods applicable to trephine biopsy specimens

Methods

Adaptation of methods in a resource‐poor setting

Further reading

INDEX

END USER LICENSE AGREEMENT

List of Tables

Chapter 1

Table 1.1 Mean values (observed range) for bone marrow cells in healthy inf...

Table 1.2 Mean values (95% ranges) for bone marrow cells in sternal or ilia...

Chapter 2

Table 2.1 Grading of bone marrow storage iron [4,5].

Table 2.2 Quantification of bone marrow reticulin and collagen: Bauermeiste...

Table 2.3 Semiquantitative grading of reticulin and collagen deposition: WH...

Table 2.4 Cytochemical and histochemical stains and their indications.

Table 2.5 Monoclonal and other antibodies useful in immunocytochemistry and...

Table 2.6 Monoclonal and other antibodies useful in flow cytometric immunop...

Table 2.7 Antigens expressed by myeloid cells and demonstrable by immunohis...

Table 2.8 Antigens expressed by lymphoid cells (B, T and NK lineages) and d...

Table 2.9 Modifications of the polymerase chain reaction (PCR) and reverse ...

Chapter 3

Table 3.1 Immunohistochemical (IHC) and

in situ

hybridization (ISH) techniq...

Table 3.2 Differential diagnosis of fungal and protozoal pathogens [105,111...

Table 3.3 Bone marrow granulomas [39,78,79,156–184] and other sources.

Table 3.4 Conditions associated with a haemophagocytic syndrome [1,89,96,23...

Table 3.5 Causes of bone marrow necrosis [35,63,123,156,423–444].

Table 3.6 Causes of Bauermeister grade 4* bone marrow fibrosis [92,148,459,...

Chapter 4

Table 4.1 The French–American–British (FAB) classification of acute myeloid...

Table 4.2 The World Health Organization (WHO) (2022 5th edition) classifica...

Table 4.3 The 2022 World Health Organization (WHO) classification of acute ...

Table 4.4 Monoclonal antibodies useful for flow cytometry immunophenotyping...

Table 4.5 Monoclonal and polyclonal antibodies useful in immunohistochemist...

Table 4.6 Cytogenetic and molecular abnormalities that lead to recognition ...

Table 4.7 Summary of criteria for lineage assignment in acute leukaemia of ...

Table 4.8 Classification of acute leukaemias of mixed phenotype or ambiguou...

Table 4.9 The 2022 World Health Organization (WHO) classification of the my...

Table 4.10 The 2022 World Health Organization (WHO) classification of myelo...

Chapter 5

Table 5.1 The World Health Organization (WHO) and International Consensus c...

Table 5.2 Fifth World Health Organization (WHO) classification and the Inte...

Table 5.3 Summary of the fifth World Health Organization (WHO) classificati...

Table 5.4 Bone marrow histological features that may be of use in distingui...

Table 5.5 World Health Organization (WHO) 2022 classification and Internati...

Table 5.6 The 2022 World Health Organization (WHO) and the International Co...

Table 5.7 Criteria for a diagnosis of systemic mastocytosis in the 2022 Wor...

Table 5.8 World Health Organization 2022 criteria for a diagnosis of chroni...

Table 5.9 World Health Organization 2022 diagnostic criteria for myelodyspl...

Table 5.10 The more common of the myeloid and lymphoid neoplasms associated...

Chapter 6

Table 6.1 Summary of the 2022 World Health Organization (WHO) classificatio...

Table 6.2 Summary of the 2022 World Health Organization (WHO) categories of...

Table 6.3 Summary of the 2022 World Health Organization (WHO) classificatio...

Table 6.4 Subclassification of adult T‐cell leukaemia/lymphoma (ATLL) [461,...

Table 6.5 Relationship between some cytogenetic and molecular genetic abnor...

Table 6.6 Summary of the 2022 World Health Organization (WHO) classificatio...

Table 6.7 A comparison of genotypic and phenotypic features of the neoplast...

Table 6.8 Epstein–Barr virus‐related lymphomas and non‐neoplastic lymphopro...

Table 6.9 The 2022 World Health Organization (WHO) classification of lympho...

Chapter 7

Table 7.1 The International Consensus Classification of multiple myeloma (A...

Table 7.2 Risk stratification in plasma cell myeloma/multiple myeloma.

Table 7.3 Monoclonal gammopathies (derived from references 2, 187 and other...

Chapter 8

Table 8.1 Causes of congenital sideroblastic anaemia. [2,6–10].

Table 8.2 Genetic, peripheral blood and bone marrow features of the congeni...

Table 8.3 Drugs most often implicated in agranulocytosis.

Table 8.4 Diagnostic criteria for idiopathic hypereosinophilic syndrome.

Chapter 9

Table 9.1 Causes of aplastic anaemia.

Chapter 10

Table 10.1 Antigens expressed by non‐haemopoietic cells, useful for the dem...

Table 10.2 Expression of cytokeratin 7 (CK7), cytokeratin 20 (CK20) and oth...

Table 10.3 Some characteristic acquired cytogenetic and molecular genetic a...

List of Illustrations

Chapter 1

Fig. 1.1 Bone marrow (BM) trephine biopsy section showing normal bone struct...

Fig. 1.2 BM trephine biopsy section showing woven bone (pale pink; without l...

Fig. 1.3 BM trephine biopsy section showing normal bone structure; there are...

Fig. 1.4 BM trephine biopsy section from a child showing endochondrial ossif...

Fig. 1.5 BM trephine biopsy section from a child showing endochondrial ossif...

Fig. 1.6 BM trephine biopsy section from an adult showing cartilage adjacent...

Fig. 1.7 BM trephine biopsy section showing a longitudinal section of an art...

Fig. 1.8 Computed tomography (CT) scan of the pelvis showing a trephine biop...

Fig. 1.9 Section of normal BM: normal distribution of all three haemopoietic...

Fig. 1.10 Aspirate of normal BM: fragment showing normal cellularity. May–Gr...

Fig. 1.11 Mean and 95% range of cellularity at various ages of anterior ilia...

Fig. 1.12 Mean value of bone marrow cellularity at various ages expressed as...

Fig. 1.13 A section of a trephine biopsy specimen of adequate size from a pa...

Fig. 1.14 A semi‐diagrammatic representation of granulopoiesis and erythropo...

Fig. 1.15 BM aspirate: an erythroid island. MGG ×100.

Fig. 1.16 Aspirate of normal BM: a proerythroblast, an intermediate erythrob...

Fig. 1.17 Aspirate of normal BM: early, intermediate and late erythroblasts ...

Fig. 1.18 Section of normal BM: an erythroid island (centre). Resin‐embedded...

Fig. 1.19 Section of normal BM: an erythroid island containing intermediate ...

Fig. 1.20 Section of normal BM: an erythroid island containing early and int...

Fig. 1.21 Section of normal BM: erythroid island containing three early, one...

Fig. 1.22 Section of normal BM: erythroid island showing intermediate and la...

Fig. 1.23 Syncytial appearance of erythroblasts in an erythroid island in se...

Fig. 1.24 Aspirate of normal BM: a myeloblast, three neutrophils and two mon...

Fig. 1.25 Aspirate of normal BM: a myeloblast and a promyelocyte (centre), a...

Fig. 1.26 Section of normal BM: myeloblasts and promyelocytes adjacent to a ...

Fig. 1.27 Section of normal BM: promyelocytes, myelocytes and maturing neutr...

Fig. 1.28 Aspirate of normal BM: a macrophage containing granular and refrac...

Fig. 1.29 Section of normal BM: a macrophage containing cellular debris. Res...

Fig. 1.30 Section of trephine biopsy specimen showing a network of dendritic...

Fig. 1.31 Section of trephine biopsy specimen showing a network of stromal d...

Fig. 1.32 Aspirate of normal BM: an immature megakaryocyte with a polyploid ...

Fig. 1.33 Aspirate of normal BM: a mature megakaryocyte with a lobated nucle...

Fig. 1.34 Aspirate of normal BM: a late megakaryocyte that has shed most of ...

Fig. 1.35 Aspirate of non‐infiltrated BM from a patient with Hodgkin lymphom...

Fig. 1.36 Section of normal BM showing cells of all haemopoietic lineages in...

Fig. 1.37 Section of normal BM showing a normal megakaryocyte and other norm...

Fig. 1.38 Section of normal BM showing a normal mature megakaryocyte and a ‘...

Fig. 1.39 Section of a trephine biopsy specimen from a patient with polycyth...

Fig. 1.40 Section of a trephine biopsy specimen from a patient with acquired...

Fig. 1.41 Aspirate of normal BM: a mast cell and a normoblast; the mast cell...

Fig. 1.42 Section of a trephine biopsy specimen from a patient with renal fa...

Fig. 1.43 Section of a trephine biopsy specimen showing a reactive increase ...

Fig. 1.44 Sections of a trephine biopsy specimen showing a reactive mast cel...

Fig. 1.45 Aspirate of normal BM: two osteoblasts; note the eccentric nucleus...

Fig. 1.46 Aspirate of normal BM: an osteoclast; note the highly granular cyt...

Fig. 1.47 Section of normal BM: a bone spicule containing an osteocyte; note...

Fig. 1.48 Section of BM from a patient with Fanconi anaemia: the trabecula i...

Fig. 1.49 Trephine biopsy sections showing normal osteoblasts in the bone ma...

Fig. 1.50 (a) Section of BM from a patient with renal osteodystrophy: an ost...

Fig. 1.51 BM aspirate: a fat cell. MGG ×50.

Fig. 1.52 Aspirate of BM from a patient with an inflammatory condition: thre...

Fig. 1.53 Section of BM from a patient with Hodgkin lymphoma (without marrow...

Fig. 1.54 The percentage of the intertrabecular space occupied by cells of d...

Fig. 1.55 BM aspirate showing increased haemosiderin. MGG ×50.

Fig. 1.56 BM trephine biopsy section from a patient in whom amyloidosis was ...

Fig. 1.57 Screen‐shot of digital images (Halo AP, Indica Labs) from a patien...

Fig. 1.58 BM aspirate showing the effect of fixing and staining the film bef...

Fig. 1.59 Vena cava scraping showing endothelial cells; similar cells are oc...

Fig. 1.60 BM aspirate: epithelial cells. MGG ×10.

Fig. 1.61 Crystals of glove powder in a BM aspirate. MGG ×40.

Fig. 1.62 BM trephine biopsy section, crushed bone. H&E ×20.

Fig. 1.63 BM trephine biopsy section showing apparently empty intertrabecula...

Fig. 1.64 BM trephine biopsy section from a patient with chronic lymphocytic...

Fig. 1.65 BM trephine biopsy section showing nuclei that appear glassy and h...

Fig. 1.66 BM section from a patient with multiple myeloma showing both incre...

Fig. 1.67 BM trephine biopsy section showing megakaryocytes surrounded by an...

Fig. 1.68 BM trephine biopsy specimen showing an artefact caused by using a ...

Fig. 1.69 BM trephine biopsy specimen showing displacement of bony trabecula...

Fig. 1.70 An inclusion of paediatric cartilage in a trephine biopsy specimen...

Fig. 1.71 BM trephine biopsy showing a piece of epidermis which has been dri...

Fig. 1.72 Trephine biopsy showing striated muscle which has been driven into...

Fig. 1.73 A hair follicle and ducts of a sweat gland which have been driven ...

Fig. 1.74 BM trephine biopsy showing sweat glands which have been driven int...

Fig. 1.75 Section of BM trephine biopsy specimen showing synovium on the per...

Fig. 1.76 Section of trephine biopsy specimen showing a gouty tophus which h...

Fig. 1.77 BM trephine biopsy specimen showing dysplastic bladder epithelium ...

Fig. 1.78 BM trephine biopsy specimen showing a needle track from a bone mar...

Fig. 1.79 BM trephine biopsy specimen showing a linear scar resulting from d...

Fig. 1.80 Section of BM trephine biopsy specimen from an intravenous drug ab...

Chapter 2

Fig . 2.1 Aspirate of normal bone marrow (BM): bluish‐black iron (haemosider...

Fig. 2.2 Aspirate of normal BM: a fragment with no stainable iron. Perls sta...

Fig. 2.3 BM aspirate from a healthy volunteer showing a normal sideroblast. ...

Fig. 2.4 BM aspirate from a patient with chronic alcoholism showing haemosid...

Fig. 2.5 Section of BM showing haemosiderin within macrophages in a human im...

Fig. 2.6 Section of BM trephine biopsy specimen showing haemosiderin in stro...

Fig. 2.7 Section of normal BM showing macrophage containing haemosiderin. Re...

Fig. 2.8 Section of trephine biopsy specimen from a child with iron overload...

Fig. 2.9 Section of normal BM: reticulin grade 0 of 4 (World Health Organiza...

Fig. 2.10 Section of normal BM: reticulin grade 1 of 4 (WHO MF‐0), showing s...

Fig. 2.11 Section of normal BM: reticulin grade 2 of 4 (WHO MF‐1), showing a...

Fig. 2.12 Section of abnormal BM: reticulin grade 3 of 4 (WHO MF‐2), showing...

Fig. 2.13 Section of abnormal BM: reticulin grade 4 of 4 (WHO MF‐3), showing...

Fig. 2.14 Section of trephine biopsy specimen from a patient with large gran...

Fig. 2.15 (a) Scatter plot showing normal cellular composition of a bone mar...

Fig. 2.16 Section of trephine biopsy specimen from a patient with a myelodys...

Fig. 2.17 Section of trephine biopsy specimen from a patient with a French–A...

Fig. 2.18 Section of trephine biopsy specimen from a patient with a myelodys...

Fig. 2.19 Section of trephine biopsy specimen showing pericapillary plasma c...

Fig. 2.20 Sections of trephine biopsy specimens showing E‐cadherin expressio...

Fig. 2.21 BM trephine biopsy section from a patient with diffuse large B‐cel...

Fig. 2.22 A karyogram showing t(11;14)(q13.3;q32) in mantle cell lymphoma. (...

Fig. 2.23 Diagrammatic representation illustrating the principles of fluores...

Fig. 2.24 Diagrammatic representation illustrating the principles of FISH, u...

Fig. 2.25 Diagrammatic representation illustrating the principles of FISH, u...

Fig. 2.26 Diagrammatic representation illustrating the principles of FISH, u...

Fig. 2.27 Diagrammatic representation of triple colour FISH, a technique use...

Fig. 2.28 Diagrammatic representation of the demonstration of an isochromoso...

Fig. 2.29 Diagrammatic representation of the use of FISH to demonstrate chro...

Fig. 2.30

In situ

hybridization showing (a) κ and (b) λ...

Fig. 2.31 Polyacrylamide gel stained with ethidium bromide and visualized wi...

Fig. 2.32 (a, b) Clonality PCR – ABI Fluorescent GeneScan showing polyclonal...

Fig. 2.33 Ultrastructural examination in Sézary syndrome showing a...

Chapter 3

Fig . 3.1 Peripheral blood (PB), bacterial infection, left shift and toxic g...

Fig. 3.2 PB, bacterial infection, monocytosis and neutrophilia. MGG ×100.

Fig. 3.3 Bone marrow (BM) aspirate film from a patient with severe infection...

Fig. 3.4 A binucleated Mott cell in a patient with marked bone marrow plasma...

Fig. 3.5 BM aspirate from a patient with human immunodeficiency virus (HIV) ...

Fig. 3.6 BM aspirate from a patient with lepromatous leprosy showing bacilli...

Fig. 3.7 BM trephine biopsy section, bacterial infection with leukaemoid rea...

Fig. 3.8 Section of BM trephine specimen showing neutrophil shadows within m...

Fig. 3.9 Intracellular ehrlichiae in a BM trephine biopsy section from a pat...

Fig. 3.10 PB, infectious mononucleosis, atypical lymphocytes. MGG ×100.

Fig. 3.11 PB, COVID‐19 (corona virus disease 2019), plasmacytoid lymphocyte....

Fig. 3.12 BM aspirate: haemophagocytosis and toxic changes in some neutrophi...

Fig. 3.13 BM aspirate: platelets within a macrophage in a patient with sever...

Fig. 3.14 BM trephine biopsy section from a patient with infectious mononucl...

Fig. 3.15 BM trephine biopsy section from a patient with infectious mononucl...

Fig. 3.16 BM trephine biopsy section from a patient with infectious mononucl...

Fig. 3.17 BM trephine biopsy section from a patient with infectious mononucl...

Fig. 3.18 BM trephine biopsy section from a patient with human herpesvirus 6...

Fig. 3.19 BM trephine biopsy section from an HIV‐positive patient with human...

Fig. 3.20 BM trephine biopsy section from an HIV‐positive patient with HHV8‐...

Fig. 3.21 BM trephine biopsy section from an HIV‐positive patient with HHV8‐...

Fig. 3.22 BM trephine biopsy section from a renal transplant patient with cy...

Fig. 3.23 BM trephine biopsy section from a patient with parvovirus B19 infe...

Fig. 3.24 BM trephine biopsy section from a patient with infectious mononucl...

Fig. 3.25 BM trephine biopsy section from a patient with hepatitis C infecti...

Fig. 3.26 BM aspirate. Histoplasmosis in a patient with AIDS, showing numero...

Fig. 3.27 BM aspirate. (a) Budding

Cryptococcus

in an HIV‐positive man. MGG ...

Fig. 3.28 BM aspirate.

Talaromyces marneffei

(previously

Penicillium marneff

...

Fig. 3.29 BM trephine biopsy section from a patient with AIDS showing

Histop

...

Fig. 3.30 BM trephine biopsy section,

Cryptococcus neoformans

in a patient w...

Fig. 3.31 Section of BM trephine biopsy specimen in a patient with AIDS with...

Fig. 3.32 BM aspirate, leishmaniasis, showing a macrophage containing numero...

Fig. 3.33 BM aspirate, falciparum malaria, showing two macrophages containin...

Fig. 3.34 Composite image of bone marrow aspirate film and trephine biopsy i...

Fig. 3.35 BM aspirate from a patient with falciparum malaria showing gametoc...

Fig. 3.36 BM aspirate from a patient with filariasis showing a microfilaria....

Fig. 3.37 BM aspirate showing

Toxoplasma gondii

, in a patient who had had a ...

Fig. 3.38 BM trephine biopsy section from an HIV‐positive man showing

Leishm

...

Fig. 3.39 BM trephine biopsy section from a patient with Chagas disease show...

Fig. 3.40 BM trephine biopsy section, toxoplasmosis, showing a small granulo...

Fig. 3.41 BM trephine biopsy section, lipid granuloma. H&E ×40.

Fig. 3.42 BM trephine biopsy section, miliary tuberculosis, showing an epith...

Fig. 3.43 BM trephine biopsy section, miliary tuberculosis, showing a granul...

Fig. 3.44 BM trephine biopsy section from a patient with AIDS and disseminat...

Fig. 3.45 BM trephine biopsy section from a patient with AIDS and

Mycobacter

...

Fig. 3.46 BM trephine biopsy sections from a patient with

Cryptococcus neofo

...

Fig. 3.47 BM trephine biopsy section showing a reactive granuloma in a patie...

Fig. 3.48 BM trephine biopsy section, plasma cell myeloma, showing large num...

Fig. 3.49 BM trephine biopsy, sarcoidosis, showing a granuloma with a giant ...

Fig. 3.50 Section of BM trephine biopsy. (a) A reactive lymphoid nodule and ...

Fig. 3.51 Section of BM trephine biopsy showing a secondary lymphoid follicl...

Fig. 3.52 BM aspirate film showing a Russell body in a plasma cell in a pati...

Fig. 3.53 BM trephine biopsy section, myelodysplastic syndrome, showing prom...

Fig. 3.54 Giemsa‐stained section of a biopsy specimen section from a patient...

Fig. 3.55 BM trephine biopsy section showing a reactive increase in macropha...

Fig. 3.56 PB film from a child with familial lymphohistiocytosis showing aty...

Fig. 3.57 BM aspirate, reactive haemophagocytosis, in a patient with both st...

Fig. 3.58 BM aspirate, reactive haemophagocytosis, showing an iron‐laden mac...

Fig. 3.59 BM aspirate, familial lymphohistiocytosis, showing haemophagocytos...

Fig. 3.60 BM aspirate from a patient with haemophagocytosis complicating Hod...

Fig. 3.61 BM trephine biopsy section, AIDS, showing increased cellularity, d...

Fig. 3.62 BM sections from two patient with a haemophagocytic syndrome. (a) ...

Fig. 3.63 BM trephine biopsy section, AIDS, showing clustering of megakaryoc...

Fig. 3.64 BM trephine biopsy section, AIDS, showing increased cellularity an...

Fig. 3.65 BM trephine biopsy section, AIDS, showing a polymorphous lymphoid ...

Fig. 3.66 BM trephine biopsy section, AIDS, showing reticulin fibrosis (grad...

Fig. 3.67 BM aspirate, bone marrow necrosis, showing amorphous debris contai...

Fig. 3.68 BM trephine biopsy section showing necrosis in a marrow infiltrate...

Fig. 3.69 BM trephine biopsy section showing new bone formation in an area o...

Fig. 3.70 BM trephine biopsy section from a patient with acute myeloid leuka...

Fig. 3.71 BM trephine biopsy section, repair following marrow necrosis, show...

Fig. 3.72 BM aspirate, gelatinous transformation, showing amorphous purplish...

Fig. 3.73 BM trephine biopsy, gelatinous transformation, showing replacement...

Fig. 3.74 BM trephine biopsy section showing marrow infiltrated by breast ca...

Chapter 4

Fig. 4.1 Section of bone marrow (BM) trephine biopsy specimen, hypoplastic a...

Fig. 4.2 Section of BM trephine biopsy specimen, hypoplastic AML (same patie...

Fig. 4.3 BM aspirate from a patient with French–American–British (FAB) M1 AM...

Fig. 4.4 BM aspirate from a patient with FAB M2 AML showing myeloblasts and ...

Fig. 4.5 Peripheral blood (PB) film from a patient with acute eosinophilic l...

Fig. 4.6 BM aspirate from a patient with acute eosinophilic leukaemia (same ...

Fig. 4.7 Section of BM trephine biopsy specimen from a patient with acute eo...

Fig. 4.8 Section of BM trephine biopsy specimen from a patient with acute eo...

Fig. 4.9 BM aspirate film, FAB M4 AML, showing four myeloblasts, one monobla...

Fig. 4.10 BM aspirate film, FAB M5a AML, showing large blast cells with mode...

Fig. 4.11 BM aspirate film, FAB M5b AML, showing monoblasts, promonocytes an...

Fig. 4.12 BM trephine biopsy section, FAB M5b AML, showing replacement of ha...

Fig. 4.13 BM trephine biopsy section, FAB M5a AML, showing monoblasts, which...

Fig. 4.14 BM aspirate film from a patient with M6 AML, showing two myeloblas...

Fig. 4.15 Section of BM trephine biopsy specimen, M6 AML, showing a disorgan...

Fig. 4.16 Section of BM trephine biopsy specimen, M6 AML, showing disorganiz...

Fig. 4.17 PB film from a patient with M7 AML showing a micromegakaryocyte wi...

Fig. 4.18 BM aspirate from a patient with t(8;21)(q22;q22.1) showing three b...

Fig. 4.19 BM aspirate from a patient with inv(16) (FAB M4 AML with eosinophi...

Fig. 4.20 Section of BM trephine biopsy specimen from a patient with inv(16)...

Fig. 4.21 PB film, hypogranular/microgranular variant of acute promyelocytic...

Fig. 4.22 BM aspirate film, hypergranular acute promyelocytic leukaemia, sho...

Fig. 4.23 BM aspirate from a patient with hypergranular acute promyelocytic ...

Fig. 4.24 Section of BM trephine biopsy specimen from a patient with hypergr...

Fig. 4.25 BM aspirate film from a patient with t(6;9)(p22.3;q34.1) showing n...

Fig. 4.26 BM aspirate film in AML associated with inv(3)(q21.3q26.2) showing...

Fig. 4.27 PB film from a child with acute megakaryoblastic leukaemia associa...

Fig. 4.28 BM film from a patient with

NPM1

‐mutated AML showing blast cells w...

Fig. 4.29 PB film from a patient with AML, myelodysplasia related (AML‐MR) s...

Fig. 4.30 PB film from a patient with AML‐MR (originally diagnosed as FAB M0...

Fig. 4.31 BM film from a patient with AML‐MR (same patient as Fig. 4.29); ce...

Fig. 4.32 BM film from a patient with AML‐MR showing severe dysplasia of cel...

Fig. 4.33 BM aspirate from a patient with AML‐MR showing a dysplastic binucl...

Fig. 4.34 BM aspirate from a patient with therapy‐related AML (t‐AML) (FAB M...

Fig. 4.35 BM aspirate from a patient with t‐AML (same patient as Fig. 4.34) ...

Fig. 4.36 BM aspirate from a patient with AML with minimal differentiation (...

Fig. 4.37 BM aspirate from a patient with AML without maturation (FAB M1 AML...

Fig. 4.38 Section of BM trephine biopsy specimen from a patient with AML wit...

Fig. 4.39 BM aspirate from a patient with AML with maturation (FAB M2 AML) s...

Fig. 4.40 Section of BM trephine biopsy specimen from a patient with AML wit...

Fig. 4.41 BM aspirate in acute monoblastic leukaemia (FAB M5a category) show...

Fig. 4.42 BM aspirate in acute monocytic leukaemia (FAB M5b category) showin...

Fig. 4.43 PB film from a patient with acute erythroleukaemia showing a circu...

Fig. 4.44 Acute erythroid leukaemia. (a) BM aspirate showing early erythroid...

Fig. 4.45 Section of BM trephine biopsy specimen, acute megakaryoblastic leu...

Fig. 4.46 PB film of a patient with acute basophilic leukaemia showing blast...

Fig. 4.47 PB film of a patient with acute basophilic leukaemia showing that ...

Fig. 4.48 PB film of a baby with Down syndrome and transient abnormal myelop...

Fig. 4.49 BM aspirate of a patient with Down syndrome and acute megakaryobla...

Fig. 4.50 PB film from a patient with myelodysplastic neoplasm/syndrome (MDS...

Fig. 4.51 BM aspirate from a patient with MDS showing a normoblast (top righ...

Fig. 4.52 BM aspirate, from a patient with MDS showing a binucleated microme...

Fig. 4.53 BM aspirate, from a patient with the 5q− syndrome, showing a megak...

Fig. 4.54 BM aspirate, from a patient with MDS showing numerous ring siderob...

Fig. 4.55 BM trephine biopsy section, from a patient with showing marked hyp...

Fig. 4.56 BM trephine biopsy section, from a patient with a condition previo...

Fig. 4.57 BM trephine biopsy section in MDS showing numerous immature erythr...

Fig. 4.58 BM trephine biopsy section from a patient with MDS showing an aggr...

Fig. 4.59 BM trephine biopsy section from a patient with MDS showing a hyper...

Fig. 4.60 BM trephine biopsy section, post‐cytotoxic MDS, showing small dysp...

Fig. 4.61 Trephine biopsy section from a patient with MDS showing a clump of...

Fig. 4.62 Trephine biopsy section from a patient with MDS showing one normal...

Fig. 4.63 Trephine biopsy section from a patient with MDS previously categor...

Fig. 4.64 Trephine biopsy section from a patient with MDS previously categor...

Fig. 4.65 BM aspirate from a case categorized as MDS with ring sideroblasts ...

Fig. 4.66 BM clot section from a case categorized as MDS with ring siderobla...

Fig. 4.67 BM aspirate from a patient with MDS showing erythroid hyperplasia ...

Fig. 4.68 BM trephine biopsy section, MDS‐IB, showing dysplastic megakaryocy...

Fig. 4.69 BM trephine biopsy sections from a patient with MDS with increased...

Fig. 4.70 BM trephine biopsy section from a human immunodeficiency virus (HI...

Fig. 4.71 BM trephine biopsy section from a patient with MDS categorized as ...

Fig. 4.72 BM trephine biopsy section from a patient with T‐cell lymphoma wit...

Fig. 4.73 PB film from a patient with blastic plasmacytoid dendritic cell ne...

Fig. 4.74 PB film from a patient with blastic plasmacytoid dendritic cell ne...

Fig. 4.75 BM aspirate film from a patient with blastic plasmacytoid dendriti...

Fig. 4.76 BM aspirate film from a patient with blastic plasmacytoid dendriti...

Fig. 4.77 Trephine biopsy sections from patients with blastic plasmacytoid d...

Fig. 4.78 Trephine biopsy section from a patient with blastic plasmacytoid d...

Fig. 4.79 PB film from a patient with malignant histiocytosis showing anaemi...

Fig. 4.80 BM aspirate showing infiltration in histiocytic sarcoma. (With tha...

Fig. 4.81 BM trephine biopsy sections showing collections of abnormal cells ...

Fig. 4.82 BM from a patient with AML with t(9;11)(p21.3;q23.3), simulating m...

Fig. 4.83 BM aspirate film in Langerhans cell histiocytosis. MGG ×100....

Fig. 4.84 BM trephine biopsy section in Langerhans cell histiocytosis showin...

Fig. 4.85 Trephine biopsy sections from a patient with Erdheim–Chester disea...

Chapter 5

Fig. 5.1 World Health Organization (WHO) 2022 criteria for a diagnosis of ch...

Fig. 5.2 Peripheral blood (PB) from a patient with CML showing neutrophils a...

Fig. 5.3 Bone marrow (BM) aspirate film from a patient with CML showing an i...

Fig. 5.4 BM aspirate film, CML, showing a storage cell with characteristics ...

Fig. 5.5 BM aspirate showing two proerythroblasts, one with cytoplasmic bleb...

Fig. 5.6 BM trephine biopsy section, CML, showing a packed marrow with a mar...

Fig. 5.7 BM trephine biopsy section, CML, showing a marked increase in granu...

Fig. 5.8 BM trephine biopsy section, CML, with a prominent megakaryocytic co...

Fig. 5.9 BM trephine biopsy section, CML, with a prominent megakaryocytic co...

Fig. 5.10 BM trephine biopsy section, CML with fibrosis, showing marked coll...

Fig. 5.11 BM trephine biopsy section, CML in accelerated phase, showing accu...

Fig. 5.12 BM trephine biopsy section in CML presenting with isolated thrombo...

Fig. 5.13 Section of BM trephine biopsy specimen from a patient presenting i...

Fig. 5.14 PB film in chronic neutrophilic leukaemia showing an increase of m...

Fig. 5.15 BM aspirate film in chronic neutrophilic leukaemia showing an incr...

Fig. 5.16 (a) BM aspirate film from a patient with a neutrophilic leukaemoid...

Fig. 5.17 The 2022 WHO and International Consensus Classification (ICC) crit...

Fig. 5.18 BM aspirate film, polycythaemia vera, showing a markedly hypercell...

Fig. 5.19 BM trephine biopsy section, polycythaemia vera, showing hypercellu...

Fig. 5.20 BM trephine biopsy section, polycythaemia vera with a

JAK2

exon 12...

Fig. 5.21 The 2022 WHO criteria for a diagnosis of essential thrombocythaemi...

Fig. 5.22 BM aspirate, essential thrombocythaemia, showing four megakaryocyt...

Fig. 5.23 BM trephine biopsy section, essential thrombocythaemia, showing a ...

Fig. 5.24 BM trephine biopsy section, essential thrombocythaemia, showing in...

Fig. 5.25 The 2022 WHO criteria for a diagnosis of prefibrotic primary myelo...

Fig. 5.26 The 2022 WHO and ICC criteria for a diagnosis of the overt fibroti...

Fig. 5.27 PB film, primary myelofibrosis, showing anisocytosis, poikilocytos...

Fig. 5.28 BM trephine biopsy section, prefibrotic primary myelofibrosis, sho...

Fig. 5.29 BM trephine biopsy section, primary myelofibrosis, cellular phase,...

Fig. 5.30 BM trephine biopsy section, primary myelofibrosis. (a) Marked hype...

Fig. 5.31 BM trephine biopsy section, primary myelofibrosis (fibrotic phase)...

Fig. 5.32 BM trephine biopsy section, primary myelofibrosis (fibrotic phase)...

Fig. 5.33 BM trephine biopsy section, osteomyelosclerosis, showing irregular...

Fig. 5.34 BM trephine biopsy section from a patient with osteomyelosclerosis...

Fig. 5.35 BM aspirate film, chronic eosinophilic leukaemia, not otherwise sp...

Fig. 5.36 BM trephine biopsy section, CEL, NOS, showing that normal haemopoi...

Fig. 5.37 A flow chart showing the diagnostic pathway for investigation of u...

Fig. 5.38 PB, juvenile myelomonocytic leukaemia (JMML), showing a monocyte, ...

Fig. 5.39 (a) Kleihauer test on PB of a patient with JMML (same patient as F...

Fig. 5.40 BM aspirate film, JMML, showing granulocyte precursors and a dyspl...

Fig. 5.41 PB film, systemic mastocytosis, showing an abnormal hypogranular m...

Fig. 5.42 BM aspirate film, systemic mastocytosis, showing an intensely hype...

Fig. 5.43 BM aspirate film, systemic mastocytosis, showing mast cells within...

Fig. 5.44 BM aspirate film, systemic mastocytosis, showing two abnormal mast...

Fig. 5.45 BM trephine biopsy section, systemic mastocytosis, showing marked ...

Fig. 5.46 BM trephine biopsy section, systemic mastocytosis, showing concent...

Fig. 5.47 BM trephine biopsy section, systemic mastocytosis (same patient as...

Fig. 5.48 BM trephine biopsy section, systemic mastocytosis (same patient as...

Fig. 5.49 BM trephine biopsy section, systemic mastocytosis, showing spindle...

Fig. 5.50 BM trephine biopsy section, systemic mastocytosis (same patient as...

Fig. 5.51 BM trephine biopsy section, systemic mastocytosis, showing increas...

Fig. 5.52 BM trephine biopsy section, systemic mastocytosis (same patient as...

Fig. 5.53 BM trephine biopsy section, systemic mastocytosis showing expressi...

Fig. 5.54 PB film in mast cell leukaemia showing circulating abnormal mast c...

Fig. 5.55 BM trephine biopsy section from a patient with mast cell leukaemia...

Fig. 5.56 PB film in chronic myelomonocytic leukaemia (CMML) showing large, ...

Fig. 5.57 BM aspirate, CMML, showing increased granulocytes and precursors. ...

Fig. 5.58 BM trephine biopsy section from a patient with CMML showing increa...

Fig. 5.59 Trephine biopsy section in CMML showing a plasmacytoid dendritic c...

Fig. 5.60 BM trephine biopsy section from a patient with CMML evolving into ...

Fig. 5.61 PB film, atypical chronic myeloid leukaemia/myelodysplastic/myelop...

Fig. 5.62 BM aspirate film, aCML/MDS/MPN‐N (same patient as Fig. 5.61), show...

Fig. 5.63 BM trephine biopsy section, aCML/MDS/MPN‐N showing increased granu...

Fig. 5.64 PB film from a case designated MDS/MPN with ring sideroblasts and ...

Fig. 5.65 Trephine biopsy section from a case designated MDS/MPN‐RS‐T showin...

Fig. 5.66 PB film from a patient with a myeloproliferative neoplasm associat...

Fig. 5.67 BM film from a patient with a myeloproliferative neoplasm associat...

Fig. 5.68 BM trephine biopsy section from a patient with a myeloproliferativ...

Fig. 5.69 BM aspirate film from a patient with the features of a chronic eos...

Fig. 5.70 BM aspirate film from a patient with features of CMML with eosinop...

Fig. 5.71 Trephine biopsy section from a patient presenting with eosinophili...

Fig. 5.72 BM aspirate film from a patient with an MPN associated with

PCM1::

...

Chapter 6

Fig. 6.1 Patterns of bone marrow infiltration observed in lymphoproliferativ...

Fig. 6.2 Bone marrow (BM) aspirate, acute lymphoblastic leukaemia (ALL), Fre...

Fig. 6.3 BM aspirate, FAB L2 ALL, showing large pleomorphic blast cells. MGG...

Fig. 6.4 BM trephine biopsy section, ALL, showing diffuse infiltration by pr...

Fig. 6.5 BM trephine biopsy section, ALL, showing new bone formation and BM ...

Fig. 6.6 BM trephine biopsy section from a 3‐year‐old child with an infectio...

Fig. 6.7 Peripheral blood (PB) film, chronic lymphocytic leukaemia (CLL), sh...

Fig. 6.8 PB film, CLL/mixed cell type, showing pleomorphic lymphocytes and o...

Fig. 6.9 PB film, Richter syndrome, showing mature small lymphocytes, smear ...

Fig. 6.10 BM aspirate, Richter syndrome (same patient as Fig. 6.9), showing ...

Fig. 6.11 BM trephine biopsy section, CLL, showing mature small lymphocytes ...

Fig. 6.12 BM trephine biopsy section, CLL, showing interstitial infiltration...

Fig. 6.13 BM trephine biopsy section, CLL, showing interstitial infiltration...

Fig. 6.14 BM trephine biopsy section, CLL, showing nodular infiltration. Res...

Fig. 6.15 BM trephine biopsy section, CLL, showing diffuse infiltration (‘pa...

Fig. 6.16 BM trephine biopsy section, CLL, showing para‐immunoblasts and pro...

Fig. 6.17 BM trephine biopsy section, CLL/mixed cell type, showing pleomorph...

Fig. 6.18 BM trephine biopsy section, Richter transformation of CLL; part of...

Fig. 6.19 PB film, B‐cell prolymphocytic leukaemia (B‐PLL), showing prolymph...

Fig. 6.20 BM trephine biopsy section, B‐PLL, showing interstitial–diffuse in...

Fig. 6.21 BM trephine biopsy section, B‐PLL, showing diffuse infiltration by...

Fig. 6.22 PB film, hairy cell leukaemia, showing two hairy cells with weakly...

Fig. 6.23 BM film showing a large atypical cell in the bone marrow of a pati...

Fig. 6.24 BM trephine biopsy section, hairy cell leukaemia, showing diffuse ...

Fig. 6.25 BM trephine biopsy section, hairy cell leukaemia, showing bland nu...

Fig. 6.26 BM trephine biopsy section, hairy cell leukaemia, showing increase...

Fig. 6.27 BM trephine biopsy section, large cell transformation of hairy cel...

Fig. 6.28 PB film, lymphoplasmacytic lymphoma, showing a lymphocyte, a plasm...

Fig. 6.29 BM aspirate, lymphoplasmacytic lymphoma. MGG ×100.

Fig. 6.30 BM trephine biopsy section, lymphoplasmacytic lymphoma, showing di...

Fig. 6.31 BM trephine biopsy section, lymphoplasmacytic lymphoma, showing di...

Fig. 6.32 BM trephine biopsy section, lymphoplasmacytic lymphoma, showing di...

Fig. 6.33 BM trephine biopsy section, lymphoplasmacytic lymphoma, showing re...

Fig. 6.34 PB film, follicular lymphoma, showing very small lymphocytes with ...

Fig. 6.35 PB film, transformed follicular lymphoma, showing a centroblast. M...

Fig. 6.36 BM trephine biopsy section showing paratrabecular infiltration by ...

Fig. 6.37 BM trephine biopsy section showing minimal infiltration by low gra...

Fig. 6.38 BM trephine biopsy section, follicular lymphoma, showing diffuse i...

Fig. 6.39 BM trephine biopsy section, follicular lymphoma (same patient as F...

Fig. 6.40 BM trephine biopsy section, follicular lymphoma, showing an infilt...

Fig. 6.41 BM trephine biopsy section from a patient with follicular lymphoma...

Fig. 6.42 PB film, mantle cell lymphoma, showing pleomorphic lymphocytes. MG...

Fig. 6.43 PB film, blastoid mantle cell lymphoma, showing pleomorphic lympho...

Fig. 6.44 BM aspirate, mantle cell lymphoma, showing pleomorphic lymphocytes...

Fig. 6.45 Trephine biopsy sections, mantle cell lymphoma. (a) A mixed inters...

Fig. 6.46 BM trephine biopsy section, mucosa‐associated lymphoid tissue (MAL...

Fig. 6.47 BM trephine biopsy section from a patient with extranodal (pulmona...

Fig. 6.48 PB film, splenic marginal zone lymphoma, showing two lymphocytes, ...

Fig. 6.49 BM trephine biopsy section, splenic marginal zone lymphoma, showin...

Fig. 6.50 BM trephine biopsy section showing intrasinusoidal infiltration by...

Fig. 6.51 PB film, variant form of hairy cell leukaemia; the nuclei have pro...

Fig. 6.52 PB film, diffuse large B‐cell lymphoma, not otherwise specified (D...

Fig. 6.53 BM trephine biopsy section, DLBCL, NOS (morphological variant, cen...

Fig. 6.54 The Hans algorithm for classification of cases of DLBCL, NOS as ge...

Fig. 6.55 BM trephine biopsy section, T‐cell/histiocyte‐rich large B‐cell ly...

Fig. 6.56 BM trephine biopsy section, T‐cell/histiocyte‐rich large B‐cell ly...

Fig. 6.57 BM trephine biopsy sections from a patient with T‐cell/histiocyte‐...

Fig. 6.58 BM aspirate in intravascular large B‐cell lymphoma showing two lym...

Fig. 6.59 BM trephine biopsy section, intravascular large B‐cell lymphoma sh...

Fig. 6.60 BM trephine biopsy section, intravascular large B‐cell lymphoma sh...

Fig. 6.61 BM aspirate, immunoblastic lymphoma in a patient with the acquired...

Fig. 6.62 BM trephine biopsy section, DLBCL, NOS (morphological variant, imm...

Fig. 6.63 PB film in high grade B‐cell lymphoma with

MYC

and

BCL2

rearrangem...

Fig. 6.64 BM trephine biopsy section in high grade B‐cell lymphoma with

MYC

...

Fig. 6.65 BM aspirate, Burkitt lymphoma presenting as leukaemia in a patient...

Fig. 6.66 BM trephine biopsy section, Burkitt lymphoma in a patient with AID...

Fig. 6.67 BM trephine biopsy section, Burkitt lymphoma in a patient with AID...

Fig. 6.68 PB film, T‐ALL, showing blast cells ranging from small to medium s...

Fig. 6.69 PB film, T‐cell prolymphocytic leukaemia (T‐PLL), showing dense ir...

Fig. 6.70 BM trephine biopsy section, T‐PLL, showing large and small prolymp...

Fig. 6.71 PB film, T‐cell large granular lymphocytic leukaemia, showing two ...

Fig. 6.72 BM trephine biopsy section, T‐cell large granular lymphocytic leuk...

Fig. 6.73 BM trephine biopsy section, T‐cell large granular lymphocytic leuk...

Fig. 6.74 PB film, aggressive NK‐cell leukaemia, showing three neoplastic ly...

Fig. 6.75 BM aspirate, aggressive NK‐cell leukaemia (same patient as Fig. 6....

Fig. 6.76 BM aspirate from a 2.5‐year‐old girl with Epstein–Barr virus (EBV)...

Fig. 6.77 PB film in extranodal NK/T‐cell lymphoma, nasal type, showing two ...

Fig. 6.78 BM trephine biopsy section showing an interstitial infiltrate (sam...

Fig. 6.79 BM trephine biopsy section, CD56 expression (same patient as Fig. ...

Fig. 6.80 BM trephine biopsy section, EBV‐EBER in nuclei of lymphoma cells (...

Fig. 6.81 PB film, Sézary syndrome, showing two cells with convoluted...

Fig. 6.82 BM trephine biopsy section from a patient with Sézary syndr...

Fig. 6.83 PB film in nodal T‐follicular helper cell lymphoma, angioimmunobla...

Fig. 6.84 BM trephine biopsy section, nodal T‐follicular helper cell lymphom...

Fig. 6.85 BM trephine biopsy section, nodal T‐follicular helper cell lymphom...

Fig. 6.86 BM trephine biopsy section, nodal T‐follicular helper cell lymphom...

Fig. 6.87 PB film, adult T‐cell leukaemia/lymphoma (ATLL), showing highly pl...

Fig. 6.88 BM aspirate, ATLL, showing an infiltrate of lymphoid cells; there ...

Fig. 6.89 BM trephine biopsy section, ATLL, showing diffuse infiltration by ...

Fig. 6.90 BM trephine biopsy section, ATLL, showing diffuse infiltration by ...

Fig. 6.91 BM trephine biopsy section, ATLL, showing heavy infiltration by pl...

Fig. 6.92 BM aspirate, hepatosplenic T‐cell lymphoma, showing medium‐sized l...

Fig. 6.93 BM trephine biopsy sections, hepatosplenic T‐cell lymphoma (same p...

Fig. 6.94 PB film, anaplastic large cell lymphoma, ALK‐positive, showing lar...

Fig. 6.95 BM aspirate, anaplastic large cell lymphoma, ALK‐positive, showing...

Fig. 6.96 BM aspirate, anaplastic large cell lymphoma, ALK‐positive, showing...

Fig. 6.97 BM trephine biopsy section, anaplastic large cell lymphoma, ALK‐po...

Fig. 6.98 BM trephine biopsy section, anaplastic large cell lymphoma, ALK‐po...

Fig. 6.99 PB film, anaplastic large cell lymphoma, ALK‐negative, showing ple...

Fig. 6.100 BM aspirate, peripheral T‐cell lymphoma, NOS, showing large cells...

Fig. 6.101 BM trephine biopsy section, peripheral T‐cell lymphoma, NOS (Lenn...

Fig. 6.102 BM trephine biopsy section, peripheral T‐cell lymphoma, NOS (Lenn...

Fig. 6.103 BM aspirate, Hodgkin lymphoma in a patient with AIDS, showing a R...

Fig. 6.104 BM trephine biopsy section, nodular sclerosis classic Hodgkin lym...

Fig. 6.105 BM trephine biopsy section, nodular sclerosis classic Hodgkin lym...

Fig. 6.106 BM trephine biopsy section, nodular sclerosis classic Hodgkin lym...

Fig. 6.107 BM trephine biopsy section, nodular sclerosis classic Hodgkin lym...

Fig. 6.108 BM aspirate from an immunosuppressed patient who developed fatal ...

Fig. 6.109 BM trephine biopsy section, polymorphic post‐transplant lymphopro...

Chapter 7

Fig. 7.1 The 2022 World Health Organisation (WHO) criteria for a diagnosis o...

Fig. 7.2 2022 WHO criteria for a diagnosis of smouldering plasma cell myelom...

Fig. 7.3 Bone marrow (BM) aspirate, myeloma, showing a range of cells from a...

Fig. 7.4 BM aspirate, myeloma, showing plasmablasts, one of which is trinucl...

Fig. 7.5 BM aspirate, myeloma, showing bi‐ and trinucleated myeloma cells an...

Fig. 7.6 BM aspirate, myeloma, showing one myeloma cell with a bilobed nucle...

Fig. 7.7 BM aspirate, myeloma, showing myeloma cells, one of which has gross...

Fig. 7.8 BM aspirate, myeloma, showing myeloma cells containing numerous Aue...

Fig. 7.9 BM aspirate, myeloma, showing myeloma cells containing numerous azu...

Fig. 7.10 BM aspirate, myeloma, showing numerous Russell bodies within a Mot...

Fig. 7.11 BM aspirate, myeloma, showing two Mott cells containing multiple R...

Fig. 7.12 BM aspirate, myeloma, showing formation of a Dutcher body by invag...

Fig. 7.13 BM aspirate showing amyloid. (a) MGG ×100. (b) Congo red....

Fig. 7.14 BM trephine biopsy section, myeloma, showing an infiltrate of cyto...

Fig. 7.15 BM trephine biopsy section, myeloma, showing interstitial infiltra...

Fig. 7.16 BM trephine biopsy section, myeloma, showing diffuse infiltration ...

Fig. 7.17 BM trephine biopsy section, myeloma, showing pericapillary plasma ...

Fig. 7.18 BM trephine biopsy section, myeloma, showing a paratrabecular myel...

Fig. 7.19 BM trephine biopsy section, myeloma, showing plasma cells with mod...

Fig. 7.20 BM trephine biopsy section, myeloma (plasmablastic), showing plasm...

Fig. 7.21 BM trephine biopsy section, myeloma, showing abundant Russell bodi...

Fig. 7.22 BM trephine biopsy section, myeloma, showing a striking deposition...

Fig. 7.23 BM trephine biopsy section from a patient with treated myeloma (fo...

Fig. 7.24 BM trephine biopsy section, myeloma, showing myeloma cells with en...

Fig. 7.25 BM trephine biopsy section from a patient with light chain only my...

Fig. 7.26 BM trephine biopsy section in osteosclerotic myeloma. H&E....

Fig. 7.27 BM trephine biopsy section in myeloma showing abnormal bone struct...

Fig. 7.28 BM trephine biopsy sections from a patient with multiple myeloma w...

Fig. 7.29 PB film from a patient with both myeloma and a neutrophilic leukae...

Fig. 7.30 Proportion of plasma cells measured by trephine biopsy and bone ma...

Fig. 7.31 BM trephine biopsy section showing heavy reactive plasma cell infi...

Fig. 7.32 BM trephine biopsy section, myeloma, showing a fibroblastic reacti...

Fig. 7.33 BM aspirate, myeloma, showing a giant myeloma cell which could eas...

Fig. 7.34 BM trephine biopsy section (same patient as Fig. 7.33) showing gia...

Fig. 7.35 PB film, plasma cell leukaemia, showing marked rouleaux formation ...

Fig. 7.36 PB film of a patient with multiple myeloma and plasma cell leukaem...

Fig. 7.37 PB film from a patient presenting with plasma cell leukaemia showi...

Fig. 7.38 PB film from a patient presenting with plasma cell leukaemia showi...

Fig. 7.39 BM aspirate film showing myeloma cells with flower‐shaped nuclei. ...

Fig. 7.40 BM trephine biopsy section from a patient with plasma cell leukaem...

Fig. 7.41 WHO 2016/2022 criteria for a diagnosis of non‐IgM monoclonal gammo...

Fig. 7.42 BM aspirate, Waldenström macroglobulinaemia, showing a mast...

Fig. 7.43 BM aspirate, Waldenström macroglobulinaemia (same patient. ...

Fig. 7.44 BM trephine biopsy section, Waldenström macroglobulinaemi...

Fig. 7.45 BM trephine biopsy section showing IgM‐containing plasma...

Fig. 7.46 BM trephine biopsy sections, Waldenström macroglobulinaem...

Fig. 7.47 BM trephine biopsy sections showing amyloid in the walls of small ...

Fig. 7.48 BM trephine biopsy section showing amyloid in the walls of small b...

Fig. 7.49 BM trephine biopsy section, light chain‐associated amyloidosis (AL...

Fig. 7.50 PB film from a patient with an IgGκ paraprotein (12 g/l)...

Fig. 7.51 BM aspirate from a patient with plasma cell myeloma and associated...

Fig. 7.52 Trephine biopsy section in POEMS syndrome. (a) Collagen fibrosis, ...

Fig. 7.53 BM trephine biopsy section from a patient with POEMS and Castleman...

Chapter 8

Fig. 8.1 Bone marrow (BM) aspirate film, iron deficiency anaemia, showing er...

Fig. 8.2 BM trephine biopsy section, iron deficiency anaemia. Haematoxylin a...

Fig. 8.3 Peripheral blood (PB) film from a boy with congenital sideroblastic...

Fig. 8.4 BM aspirate film from a boy with congenital sideroblastic anaemia (...

Fig. 8.5 BM aspirate film from a boy with congenital sideroblastic anaemia (...

Fig. 8.6 BM aspirate film, β thalassaemia trait, showing erythroid...

Fig. 8.7 BM aspirate film, β thalassaemia major, showing erythroid...

Fig. 8.8 BM aspirate film, β thalassaemia major, showing erythroid...

Fig. 8.9 BM trephine biopsy section, β thalassaemia major, showing...

Fig. 8.10 BM aspirate film, haemoglobin H disease, showing marked erythroid ...

Fig. 8.11 BM aspirate film, autoimmune haemolytic anaemia, showing an erythr...

Fig. 8.12 BM aspirate film, haemoglobin C disease, showing erythroid hyperpl...

Fig. 8.13 BM trephine biopsy section, autoimmune haemolytic anaemia, showing...

Fig. 8.14 PB film, congenital dyserythropoietic anaemia (CDA) type I, showin...

Fig. 8.15 PB film, CDA type II (hereditary erythroid multinuclearity with po...

Fig. 8.16 BM aspirate film, CDA type I, showing erythroid hyperplasia and dy...

Fig. 8.17 BM aspirate film, CDA type II, showing one binucleated erythroblas...

Fig. 8.18 BM aspirate film, CDA type III, showing giant, multinucleated eryt...

Fig. 8.19 BM aspirate film, CDA type II, showing pseudo‐Gaucher cells. (a) M...

Fig. 8.20 BM clot section, CDA type I, showing marked erythroid hyperplasia ...

Fig. 8.21 BM aspirate film in transcobalamin deficiency showing (a) a megalo...

Fig. 8.22 BM aspirate film, megaloblastic anaemia, showing hyperplastic mega...

Fig. 8.23 BM trephine biopsy section, megaloblastic anaemia, showing marked ...

Fig. 8.24 BM trephine biopsy section, megaloblastic anaemia, showing several...

Fig. 8.25 BM trephine biopsy section, megaloblastic anaemia due to vitamin B

Fig. 8.26 BM aspirate film, sickle cell anaemia, showing a foamy macrophage ...

Fig. 8.27 BM aspirate, sickle cell anaemia, showing a sea‐blue histiocyte th...

Fig. 8.28 BM aspirate, sickle cell/β

0

thalassaemia compound...

Fig. 8.29 BM trephine biopsy section, sickle cell anaemia, showing sinusoid...

Fig. 8.30 Section of clotted BM aspirate showing macrophages stuffed with s...

Fig. 8.31 BM aspirate, chronic idiopathic pure red cell aplasia, showing inc...

Fig. 8.32 BM aspirate, Blackfan–Diamond syndrome, showing a single intermedi...

Fig. 8.33 BM aspirate, chronic pure red cell aplasia caused by parvovirus B1...

Fig. 8.34 BM trephine biopsy section, pure red cell aplasia, showing absence...

Fig. 8.35 BM trephine biopsy section, Blackfan–Diamond syndrome, showing pro...

Fig. 8.36 BM trephine biopsy section, chronic pure red cell aplasia, probabl...

Fig. 8.37 BM trephine biopsy section, chronic parvovirus B19‐induced pure re...

Fig. 8.38 BM aspirate film, severe congenital neutropenia, showing neutrophi...

Fig. 8.39 BM aspirate film from a patient with myelokathexis as part of the ...

Fig. 8.40 BM aspirate film from a patient with the inherited Pelger–...

Fig. 8.41 BM trephine biopsy section from a patient with agranulocytosis. Th...

Fig. 8.42 BM aspirate film, autoimmune neutropenia, showing neutrophil shado...

Fig. 8.43 BM aspirate film, idiopathic hypereosinophilic syndrome, showing e...

Fig. 8.44 BM trephine biopsy specimen, idiopathic hypereosinophilic syndrome...

Fig. 8.45 BM aspirate film, Chédiak–Higashi syndrome, showing g...

Fig. 8.46 Chédiak–Higashi syndrome. (a, b) BM aspirate, showing...

Fig. 8.47 BM aspirate film, May–Hegglin anomaly, showing two neutrophils wit...

Fig. 8.48 BM aspirate film, autoimmune thrombocytopenic purpura, showing fiv...

Fig. 8.49 BM trephine biopsy specimen, autoimmune thrombocytopenic purpura, ...

Fig. 8.50 BM trephine biopsy section in autoimmune thrombocytopenic purpura ...

Chapter 9

Fig. 9.1 Bone marrow (BM) trephine biopsy section from a patient with cancer...

Fig. 9.2 BM aspirate film from a patient with copper deficiency showing haem...

Fig. 9.3 BM aspirate film from a patient with VEXAS syndrome showing vacuola...

Fig. 9.4 BM aspirate from an intensive care ward patient with multiorgan fai...

Fig. 9.5 BM aspirate from a patient with tuberculosis showing marked dyseryt...

Fig. 9.6 BM aspirate from a patient with autoimmune haemolytic anaemia showi...

Fig. 9.7 BM aspirate from a patient with arsenic toxicity showing nuclear lo...

Fig. 9.8 BM aspirate film from a patient with small lymphocytic lymphoma sho...

Fig. 9.9 BM aspirate film from a patient with previously undiagnosed systemi...

Fig. 9.10 Peripheral blood (PB) film from a patient taking mycophenolate mof...

Fig. 9.11 PB film from a patient with gemcitabine‐induced microangiopathic h...

Fig. 9.12 BM aspirate from a patient with severe methotrexate toxicity showi...

Fig. 9.13 BM aspirate from a patient taking hydroxycarbamide for psoriasis s...

Fig. 9.14 BM aspirate, performed about 24 hours after administration of vinc...

Fig. 9.15 BM aspirate from a patient taking mycophenolate mofetil showing a ...

Fig. 9.16 BM aspirate, following chemotherapy for acute myeloid leukaemia (A...

Fig. 9.17 BM trephine biopsy section, regeneration post‐chemotherapy, showin...

Fig. 9.18 BM aspirate in lead poisoning. (a) Erythroblasts with vacuolated, ...

Fig. 9.19 BM aspirate showing dyserythropoiesis induced by arsenic. MGG...

Fig. 9.20 BM aspirate from a patient with copper deficiency caused by chelat...

Fig. 9.21 BM trephine biopsy section from a patient with copper deficiency c...

Fig. 9.22 BM trephine biopsy section showing stromal damage and radiation‐in...

Fig. 9.23 PB film showing macrocytosis with some stomatocytes, consequent on...

Fig. 9.24 BM aspirate showing macronormoblastic erythropoiesis and erythrobl...

Fig. 9.25 BM aspirate from a patient with Zieve syndrome. (a) Foamy macropha...

Fig. 9.26 BM aspirate, aplastic anaemia, showing a severely hypoplastic frag...

Fig. 9.27 BM trephine biopsy section, aplastic anaemia, showing marked hypoc...

Fig. 9.28 BM trephine biopsy section, aplastic anaemia, showing a marked red...

Fig. 9.29 BM trephine biopsy section, Fanconi anaemia, showing large, poorly...

Fig. 9.30 BM trephine biopsy section inadvertently taken from the site of pr...

Fig. 9.31 BM trephine biopsy section from a patient with essential thrombocy...

Fig. 9.32 BM trephine biopsy section in anorexia nervosa showing marked hypo...

Fig. 9.33 BM aspirate from a patient with probable Pearson syndrome showing ...

Fig. 9.34 BM aspirate from a patient with Pearson syndrome showing vacuolati...

Fig. 9.35 BM aspirate from a patient with thiamine‐responsive megaloblastic ...

Fig. 9.36 PB film in paroxysmal nocturnal haemoglobinuria (PNH) showing seve...

Fig. 9.37 BM aspirate, PNH, showing erythroid hyperplasia and a somewhat abn...

Fig. 9.38 BM trephine biopsy from a patient with evolution of PNH to aplasti...

Fig. 9.39 BM trephine biopsy section from a patient with red cell aplasia fo...

Fig. 9.40 BM trephine biopsy section showing regeneration following bone mar...

Fig. 9.41 BM aspirate film from a patient who was receiving romiplostim, sho...

Fig. 9.42 BM aspirate film from a patient with autoimmune thrombocytopenic p...

Fig. 9.43 BM trephine biopsy specimen from a patient receiving granulocyte c...

Fig. 9.44 BM trephine biopsy specimen from a patient receiving thrombopoieti...

Fig. 9.45 BM aspirate showing dyserythropoiesis in protein‐calorie malnutrit...

Fig. 9.46 BM aspirate showing a giant metamyelocyte in a patient with protei...

Fig. 9.47 BM aspirate, Gaucher disease, showing two Gaucher cells. MGG....

Fig. 9.48 BM trephine biopsy section, Gaucher disease, showing a sheet of la...

Fig. 9.49 BM trephine biopsy section in chronic myeloid leukaemia showing ps...

Fig. 9.50 BM aspirate film from a patient with β thalassaemia major ...

Fig. 9.51 BM aspirate, Niemann–Pick disease, showing foamy macrophages. MGG ...

Fig. 9.52 BM trephine biopsy section, Niemann–Pick disease, showing foamy ma...

Fig. 9.53 BM trephine biopsy section, Wolman disease, showing foamy macropha...

Fig. 9.54 BM aspirate, sickle cell anaemia, showing a foamy macrophage and a...

Fig. 9.55 BM aspirate, carcinoma of prostate, showing a clump of carcinoma c...

Fig. 9.56 BM aspirate from a patient with AML showing a sea‐blue histiocyte....

Fig. 9.57 BM trephine biopsy section from a patient with polycythaemia vera ...

Fig. 9.58 Macrophage containing grey‐green crystals in a bone marrow macroph...

Fig. 9.59 BM aspirate from a patient with cystinosis showing two macrophages...

Fig. 9.60 BM trephine biopsy section from a patient with cystinosis showing ...

Fig. 9.61 BM trephine biopsy section from a patient with cystinosis showing ...

Fig. 9.62 BM trephine biopsy sections in oxalosis. (a) H&E ×10....

Fig. 9.63 BM aspirate film from a patient with Sanfilippo syndrome showing a...

Fig. 9.64 BM aspirate, Sanfilippo syndrome, showing cells containing abnorma...

Fig. 9.65 BM trephine biopsy section showing a cholesterol embolus; choleste...

Fig. 9.66 BM trephine biopsy section from a patient with an anti‐cardiolipin...

Fig. 9.67 BM trephine biopsy section from a patient with hereditary haemorrh...

Chapter 10

Fig. 10.1 Peripheral blood (PB) film of a patient with bone marrow infiltrat...

Fig. 10.2 Bone marrow (BM) aspirate, carcinoma of prostate, showing carcinom...

Fig. 10.3 BM aspirate, malignant melanoma, showing melanoma cells containing...

Fig. 10.4 BM aspirate from a patient with metastatic malignant melanoma show...

Fig. 10.5 BM aspirate, carcinoma of kidney, showing ‘clear cells’ with volum...

Fig. 10.6 BM aspirate, carcinoid tumour, showing cells with relatively small...

Fig. 10.7 BM aspirate, neuroblastoma, showing neoplastic cells which are rel...

Fig. 10.8 BM aspirate, neuroblastoma, showing neoplastic cells forming a ros...

Fig. 10.9 BM aspirate, rhabdomyosarcoma, showing coalescing vacuoles. MGG...

Fig. 10.10 BM aspirate, carcinoma of breast, showing adenocarcinoma cells wi...

Fig. 10.11 BM aspirate, small cell carcinoma of lung, showing carcinoma cell...

Fig. 10.12 BM aspirate, metastatic carcinoma of breast. (a) MGG ×100....

Fig. 10.13 BM trephine biopsy section, carcinoma of the breast, showing oste...

Fig. 10.14 BM trephine biopsy section, carcinoma of the breast (same patient...

Fig. 10.15 BM trephine biopsy section, poorly differentiated prostatic carci...

Fig. 10.16 BM trephine biopsy section, poorly differentiated prostatic carci...

Fig. 10.17 BM trephine biopsy section, poorly differentiated prostatic carci...

Fig. 10.18 BM trephine biopsy section, well‐differentiated prostatic carcino...

Fig. 10.19 BM trephine biopsy section, adenocarcinoma, showing interstitial ...

Fig. 10.20 BM trephine biopsy section, adenocarcinoma, showing intracellular...

Fig. 10.21 BM trephine biopsy section, prostatic adenocarcinoma, showing mic...

Fig. 10.22 BM trephine biopsy section, macroglandular pattern of prostatic a...

Fig. 10.23 BM trephine biopsy section, carcinoma of the breast, showing tumo...

Fig. 10.24 BM trephine biopsy section, lobular carcinoma of breast, showing ...

Fig. 10.25 BM trephine biopsy section, metastatic adenocarcinoma from a colo...

Fig. 10.26 BM trephine biopsy section, small cell carcinoma of the bronchus,...

Fig. 10.27 BM trephine biopsy section, carcinoid tumour (unknown primary sit...

Fig. 10.28 BM trephine biopsy section, malignant melanoma, showing a focal t...

Fig. 10.29 BM trephine biopsy section, amelanotic melanoma composed of fairl...

Fig. 10.30 BM trephine biopsy section showing Kaposi sarcoma in a patient wh...

Fig. 10.31 BM trephine biopsy sections showing infiltration by angiosarcoma....

Fig. 10.32 BM trephine biopsy section, metastatic Thorotrast‐induced angiosa...

Fig. 10.33 BM trephine biopsy section, neuroblastoma, showing extensive, dif...

Fig. 10.34 BM trephine biopsy section, neuroblastoma, showing rosette format...

Fig. 10.35 BM trephine biopsy section, rhabdomyosarcoma, showing elongated c...

Fig. 10.36 BM trephine biopsy section, Ewing sarcoma, showing irregular grou...

Fig. 10.37 BM trephine biopsy section, Ewing sarcoma, showing large granules...

Fig. 10.38 Splenic haemangiolymphangioma involving the BM. H&E ×40....

Fig. 10.39 BM trephine biopsy sections showing a poorly differentiated adeno...

Fig. 10.40 BM trephine biopsy section showing neuroblastoma. Immunoperoxidas...

Fig. 10.41 BM trephine biopsy section showing minimal infiltration by neurob...

Fig. 10.42 BM trephine biopsy section showing minimal infiltration by neurob...

Fig. 10.43 BM trephine biopsy section, post‐treatment follow‐up for neurobla...

Fig. 10.44 BM aspirate showing a cluster of osteoblasts mimicking carcinoma ...

Fig. 10.45 BM trephine biopsy section, sweat gland interposition mimicking a...

Fig. 10.46 BM trephine biopsy section, signet ring carcinoma of unknown prim...

Chapter 11

Fig. 11.1 Bone marrow (BM) trephine biopsy section, osteoporosis, showing a ...

Fig. 11.2 BM trephine biopsy section, osteomalacia, showing wide osteoid sea...

Fig. 11.3 BM trephine biopsy section, primary hyperparathyroidism, showing p...

Fig. 11.4 BM trephine biopsy section, renal osteodystrophy, showing irregula...

Fig. 11.5 BM trephine biopsy section, renal osteodystrophy, showing prominen...

Fig. 11.6 BM trephine biopsy section, Paget disease of bone, showing thicken...

Fig. 11.7 BM trephine biopsy section, Paget disease of bone (same patient as...

Fig. 11.8 BM trephine biopsy section, Paget disease of bone, showing bone ma...

Fig. 11.9 BM trephine biopsy section, idiopathic osteosclerosis, showing mar...

Fig. 11.10 BM trephine biopsy section showing newly deposited woven bone on ...

Fig. 11.11 BM trephine biopsy section from a child with osteopetrosis showin...

Fig. 11.12 BM trephine biopsy section from a child with osteopetrosis showin...

Fig. 11.13 Bone marrow trephine biopsy section showing a prominent cement li...

Guide

Cover Page

Dedication Page

Title Page

Copyright Page

PREFACE TO THE SIXTH EDITION

ACKNOWLEDGEMENTS

ABBREVIATIONS

Table of Contents

Begin Reading

APPENDIX

Index

WILEY END USER LICENSE AGREEMENT

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