[Histonet] Bone marrow clot

From:Paul Bradbury

Hi Carolyn,

A few comments regarding your bone marrow problems.

Bouin's fixative is a poor choice for fixing any bone marrow specimen. 
The bone marrow clot reacts like any other clot and when fixed in Bouin 
will become very brittle after processing. A second (and major) effect 
of Bouin is to lyse most of the cytoplasmic granules present in the bone 
marrow cells. As any hematologist will confirm, these granules are a 
vital element in the recognition of the different cell lines in the bone 

A much better choice for both the core biopsy and the aspirate would be 
B-5 or one of the zinc-based substitutes. Any coagulant fixative (such 
as Bouin, B-5 or a zinc-based solution) should not the left to fix 
overnight or the tissues will become brittle. For a 4 mm bone core, 
around 2 hours at room temperature should be adequate; for a bone marrow 
clot, the time will vary according to the size, but for a clot of up to 
4 mm thick, 3 hours should be ample.

The core should be decalcified as usual (30 - 40 minutes in Cal-Ex is 
usually enough), then processed on a routine cycle.
We routinely cut bone marrow cores and aspirates at 1.5 microns without 
any problems. This thickness (or thin-ness) gives beautiful clarity to 
the bone marrow cells. B-5 will leave the usual mercury pigment. but 
this is easily removed with an iodine-thiosulphate treatment.

The use of heparinized syringes will not have any adverse effects on the 
quality of the tissue sample. The only effect they have is to prevent 
the aspirate material from clotting in the needle or the syringe.

Paul Bradbury
Kamloops, BC

Demarinis, Carolyn wrote:

>We receive bone marrow specimens collected by oncologists in their
>The bone marrow CLOT is immediately put in Bouin's fixative, fixed
>and processed in a paraffin block.
>We are having a very difficult time cutting sections from the clot
>We have no problem cutting the bone biopsy.
>I have been told the difficulty might be caused by the oncologist using
>heparanized syringes.
>Does anyone have any suggestions that might help us prepare acceptable
>slides from the clot?
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