**Author details**

Ahmed Lasfar

Address all correspondence to: ahmed.lasfar@pharmacy.rutgers.edu

Rutgers-Cancer Institute of New Jersey, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA

**Section 2**

**Pathogenicity and Diagnostic**

**Pathogenicity and Diagnostic**

**Author details**

Address all correspondence to: ahmed.lasfar@pharmacy.rutgers.edu

Rutgers University, Piscataway, NJ, USA

Rutgers-Cancer Institute of New Jersey, Ernest Mario School of Pharmacy,

Ahmed Lasfar

6 Myeloid Leukemia

**Chapter 2**

**Provisional chapter**

**Cytopathology of MDS/MPN and AML by H&E Staining**

Bone marrow (BM) clots are routinely sampled in aspiration tests, and their sections are prepared for histological observation by hematoxylin and eosin (H&E) staining. However, H&E-stained sections are considered less informative than those stained by the May-Grünwald Giemsa (M-G) stain; thus, diagnosis using H&E-stained clot samples is challenging for pathologists. In fact, the diagnostic evaluation is limited to the observation of cellular morphology and the myeloid-erythroid cell ratio. Pathologists leave cellular observation to laboratory hematologists, who generally use M-G staining. In this chapter, the utility of bone marrow clot specimens for diagnosis by H&E staining is reviewed. Specifically, the review provides a descriptive and illustrative explanation of the diagnosis of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myelodysplastic syndrome/myelocytic proliferative neoplasm (MDS/MPN) and demonstrates the possibility of diagnosis on the basis of the characteristic features of blast cells. Clot specimens appear to be useful for the diagnosis of hematopoietic dysplasia by pathologists, and this approach can provide more informative findings for hematologists.

**Keywords:** bone marrow clots, hematoxylin and eosin, acute myeloid leukemia

**Cytopathology of MDS/MPN and AML by H&E Staining**

DOI: 10.5772/intechopen.71567

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

Bone marrow (BM) clots and their specimens can be evaluated histopathologically by hematoxylin and eosin (H&E) staining [1, 2]. However, this method is considered to yield limited information regarding cellular morphology, myeloid-erythroid cell ratio, size and morphology of megakaryocytes [3], increase in multiple myeloma [4], involvement of lymphoma, and metastatic tumor such as neuroblastoma [5–7]. In particular, BM clot sections comprising sinusoidal blood are inadequate for morphological interpretation [2]. However, the cellblock technique ensures the capture of cells required for diagnosis, and laboratories routinely apply this sample preparation technique for enhancing the usability of the BM clot specimen [2, 8].

Tatsuaki Tsuruyama

**Abstract**

**1. Introduction**

Tatsuaki Tsuruyama

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.71567

**Provisional chapter**
