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Surgical Pathology Bone Marrow Specimens

Bone Marrow Specimen

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Bone marrow aspiration and biopsy are done when certain hematologic conditions are present. Some of these conditions are: anemias, erythrocytosis, polycythemia, leukopenia, unexplained leukocytosis, thrombocytopenia, or thrombocytosis. Other causes for bone marrow study may include malignant tumors, infections or whenever the physician expects a beneficial diagnostic result.

In addition to the general requisition requirements, the following information must be given under the surgical pathology specimen section: specimen source and type (biopsy, aspirate, or both), indication of whether procedure was unilateral or bilateral (and which side was aspirated), brief clinical history (reason for bone marrow) and physician who performed the bone marrow procedure. See requirements below to order special studies.


The bone marrow specimen should generally consist of:

  • Bone marrow aspirate smears (see below)
  • Peripheral blood smears (see below)
  • Core biopsy
  • Aspirate clot
  • Complete CBC work-up and/or EDTA tube performed within 24hrs of bone marrow procedure

    bonemarrow1.jpgPlace the bone marrow core and/or clot(s) in separate, sturdy containers containing 10% formalin. Send about 8 bone marrow aspirate smears. If this is not possible, then imprints of the core biopsy should be submitted. Imprint slides are made by placing the core on a slide and gently touching a sec- ond slide to the core. Do not roll the core between the slides. Rolling will cause distortion of the cells. Also send a minimum of two unstained peripheral smears made fresh on the same day as when the blood was drawn. Routine reticulocyte counts are no longer done with the exception of anemia work-ups or per physician's discretion. Retic counts should be ordered or submitted if the bone marrow is being performed for an anemia work-up or at the physician request.

The bone marrow protocol requires a complete blood count (CBC) to be completed on the day of the procedure or within 24 hours of the procedure. If the blood tests are done at your facility, send a copy of the results with the bone marrow specimen or fax them to Physicians Laboratory at 1-605-322-7222. For blood ordered through Physicians Laboratory send an EDTA tube and peripheral smears along with a completed Avera McKennan Regional Laboratory Requisition.


Click here for Bone Marrow Instructions
(non-ring hospitals)

 Client instructions for ring hospitals


Turn-around-time for bone marrow reports varies widely due to the nature of the tests performed.  If stat results are needed the physician may contact the hematopathologist by calling PL's Client Services at 605-322-7212 for a preliminary report.