Collection Manual: Bone marrow aspiration and biopsy


Description: Bone marrow specimens are submitted for the evaluation of hematopoietic diseases and for tumor staging. Specimens submitted for microscopic review include bone marrow core biopsies, touch prep, aspirate clot, and aspirate slide preparations. In addition, the most recent peripheral blood smear and its most recent CBC report must be submitted with the samples. Biopsy specimens should be submitted in zinc formalin.


MATERIALS
Zinc formalin jar (pre-filled 40ml or 60ml. CAUTION: POISON, CARCINOGEN).
Microscope slides, requisition form, biohazard transport bag.


PREPARATION

1. Complete a requisition form. White copy to the lab. Lack of data may result in specimen delay or rejection. Please include:
• Clinician name, location and date of service.
• Patient demographics: Name, address, phone number, date of birth and social security number.
• Insurance information: copy of insurance card(s) or face sheet.
• Description of tissue. If multiple parts, label each A, B ,C etc with corresponding descriptions.
• Relevant clinical history/symptoms. Attach results of the most recent CBC and differential reports.
• Specify the cell type (ie, B cell lymphoma, small cleaved cell lymphoma, etc.) if there is a known history of malignancy.
• Requests for special stains, immunofluorescence, chromosome studies etc.

2. Label the specimen jars and slides.
• Write the patient first and last name and site description on the jar(s).
• For multi-part specimens label jars A, B, C etc corresponding to the descriptions on the requisition.
• Label the slides with the patient’s first and last name and the type of specimen (ie, touch prep).


COLLECTING THE SPECIMEN

3. Immerse the specimen in formalin.

• Place specimen in 10% Zinc formalin immediately following surgical removal.
• Submit the aspirate clot and core biopsy samples in separate jars labeled A & B respectively.
• Fully immerse the specimen in formalin. Ten parts formalin to one part specimen is the advised ratio.
• Include with the specimen an unstained peripheral smear, a touch prep slide and 3-5 bone marrow
aspirate slides for Wright stain and possible special stains.

4. Prepare air-dried slides.
• Prepare an unstained peripheral smear.
• Prepare a touch prep slide.
• Prepare 3 – 5 bone marrow aspirate slides.


PACKAGING FOR TRANSPORT

5. Secure the specimens for transport.
• Verify that the biopsy jar lids are properly seated and tight.
• Place the prepared slides in slide mailer and close the lid. Collection procedures 2.3 page 1 of 2

6. Submit specimen in a biohazard transport bag.
• Seal the jars and slides in the zip-loc portion of the bag and the requisition form and CBC and differential reports in the outer sleeve.

7. Refrigeration is not required.