Bone Marrow Aspirate: Aspicular Marginal Adequate Inadequate Not performed Bone Marrow Biopsy: Aplastic Hypocellular Normocellular Hypercellular Packed Fragments of bone only Not performed Bone Marrow Cellularity: %; M:E Ratio Blasts: % of nucleated marrow cells. Auer Rods: Not noted Noted Myeloperoxidase: Negative Weak positive Positive Non-Specific Esterase: Negative Weak positive, <20% Positive, >20% Monocytes: % of nucleated marrow cells Atypical Monocytes/Monoblasts: % of nucleated marrow cells Granulocytes: % of nucleated marrow cells Erythroid Precursors % of nucleated marrow cells Plasma Cells: % of nucleated marrow cells Lymphocytes: % of nucleated marrow cells Other cell type : % of nucleated marrow cells Bone Marrow Maturation: Granulocytic Precursors: Adequate in numbers Absent Decreased in numbers Increased in numbers Granulocytic maturation: Normal Left-shift Arrested Dysgranulopoiesis: Absent Rare Minimal Moderate Marked No evaluation Monocytes: Unremarkable With dysplasia Erythroid Precursors: Adequate in numbers Absent Decreased in numbers Increased in numbers Erythroid Maturation: Normal Left-shift Arrested Dyserythropoiesis: Absent Rare Minimal Moderate Marked No evaluation Megakaryocytes: Adequate in numbers Absent Decreased in numbers Increased in numbers Dysmegakaryopoiesis: Absent Rare Minimal Moderate Marked No evaluation Special stain(s): Iron stain (bone marrow aspirate smear): None detectable Inadequate sample Minimal iron Adequate iron Mildly increased iron Markedly increased iron Ringed sideroblasts: None Occasional, <15% A few, <15% Many, >15% Iron Stain (bone marrow biopsy): Not detectable Minimal Adequate Mildly increased Markedly increased Reticulin Stain: Not increased Mildly increased Moderately increased Markedly increased Immunohistochemistry General The results of flow cytometry often represent the qualitative determination of cells and they may not accurately reflect bone marrow status because the composition of the specimen sampled for flow cytometry and the cells that survive in vitro processing can vary significantly. Thus, immunohistochemical studies are performed to ensure accurate assessment of the number and topographical distribution of cells of interest in the bone marrow biopsy or clot, which cannot be measured by flow cytometry. Plasma cells: A small population of atypical plasma cells is detected by flow cytometry, but results of flow cytometry often represent the qualitative determination of cells and they may not accurately reflect bone marrow status because the composition of the specimen sampled for flow cytometry and the cells that survive in vitro processing can vary significantly. Thus, immunohistochemical studies are performed to ensure accurate assessment of the number and the topographical distribution of cells of interest in the bone marrow biopsy or clot, which cannot be measured by flow cytometry. Lymphoid cells: A small population of atypical lymphoid cells is detected by flow cytometry, but results of flow cytometry often represent the qualitative determination of cells and they may not accurately reflect bone marrow status because the composition of the specimen sampled for flow cytometry and the cells that survive in vitro processing can vary significantly. Immunohistochemical studies are performed to ensure accurate assessment and quantification of the population of interest and to assess the topographical distribution and location of the cells of interest which cannot be measured by flow cytometry. Blasts: A small population of blasts is detected by flow cytometry, but results of flow cytometry often represent the qualitative determination of cells and they may not accurately reflect bone marrow status because the composition of the specimen sampled for flow cytometry and the cells that survive in vitro processing can vary significantly. Thus, immunohistochemical studies are performed to ensure accurate assessment of the number and topographical distribution of cells of interest in the bone marrow biopsy or clot, which cannot be measured by flow cytometry. Atypical cells: A small population of atypical cells is detected by flow cytometry, but results of flow cytometry often represent the qualitative determination of cells and they may not accurately reflect bone marrow status because the composition of the specimen sampled for flow cytometry and the cells that survive in vitro processing can vary significantly. Thus, immunohistochemical studies are performed to ensure accurate assessment of the number and the topographical distribution of cells of interest in the bone marrow biopsy or clot, which cannot be measured by flow cytometry. Flow cytometry not performed Flow Cytometry: Peripheral blood Bone marrow aspirate Bone marrow aspirates (left and right) Bone marrow biopsy Cytospin reveals: many granulocytes blasts monocytes lymphocytes plasma cells a few granulocytes blasts monocytes lymphocytes plasma cells Flow Cytometry Findings: CD34/CD117-positive Blasts ( %): The myeloblasts show normal expression of CD38, CD13, CD33 CD15 and HLA-Dr and have no phenotypic aberrancy. Granulocytes and monocytes: The maturing granulocytic precursors have normal expression of CD13, CD15, CD33, CD11b, and CD16. The monocytes have maturational expression of CD64, CD14, HLA-DR and CD33. Erythroid Precursors: The erythroid precursors have maturational expression of CD71, Glycophorin A and CD36. Immature B cells: The CD19-positive immature B cells have normal maturational expression of CD45, CD10 and CD20. Immature B cells: CD19-positive immature B cells (CD45 positive CD10 positive CD20 variable) are absent. B cells: The mature B cells have expression of CD19, CD20, and polyclonal kappa and lambda surface light chains, with variable CD23 and CD11c, without abnormal expression CD5. T cells: T cells have normal expression of CD3, CD4, CD5, CD7 and CD8. The CD56-positive NK cells or CD57-positive LGL are not overtly increased in number. The CD4/CD8 ratio is . Sample information: Received labeled with the patient's name and medical record number: PB: mL in EDTA tube(s) PB: mL in heparin tube(s) Bone marrow aspirate: Right Left mL in EDTA tube(s) Bone marrow aspirate: Right Left mL in EDTA tube(s) Bone marrow aspirate: Right Left mL in heparin tube(s) Bone marrow aspirate: Right Left mL in heparin tube(s) Bone marrow biopsy: Left Right Fresh FML piece(s) mm Bone marrow biopsy: Left Right Fresh FML piece(s) mm Bone marrow biopsy: Left Right Fresh FML piece(s) mm Stained slide(s): Unstained slide(s): Total cells obtained: Total cells obtained: x 10^6 Total cell count not determined Cell viability % Cell viability not determined Touch imprinting, RBC lysing, antibody staining, and cytospin procedures (if needed) were performed according to procedure manuals. Cytogentics: A sample has been sent for cytogenetics. The results will appear in a separate report.