Bone marrow is a soft tissue found within bone cavities that produces blood cells. There are two types - red marrow, which produces blood cells, and yellow marrow, comprised mainly of fat cells. Red marrow is present throughout the skeleton in children but shifts to predominantly the skull, sternum, vertebrae and pelvis in adults. Bone marrow biopsy and aspiration involve inserting a needle into bone to extract a tissue sample or fluid for examination under a microscope to diagnose conditions that affect blood cell production, such as leukemia, lymphoma or multiple myeloma. Complications can include pain, bleeding or infection at the biopsy site.

2. Bone marrow is a highly
cellular structure present
within the hollow cavities of
hard bone tissue
There is 2 types of bone
marrow:
A)red bone marrow
B)yellow bone marrow

3. Children:bone marrow in all bones is red
bone marrow
Adulthood:bone marrow cells in long bones
of hand and leg become non-functional and
are replaced by fat cells to form yellow bone
marrow.
the only bones to carry red bone marrow
throughout life are the vertebrae,sternum,
hip bone, and skull bones
constitutes 4% of the total body mass of
human

4. Bone marrow cells are highly functional and
continuously divide and give rise to the
different cells present in blood.
changes in bone marrow cause change in
the composition of blood which can lead to
various diseases

5.  connective tissue cells of any organ
 cells that support the function of the parenchymal
cells of that organ
 It is indirectly involved in hematopoiesis-
 release colony stimulating factor
 provides the hematopoietic microenvironment that
facilitates hematopoiesis by the parenchymal cells
Cells that constitute the bone marrow stroma are:
 fibroblasts (reticular connective tissue)
 macrophages
 adipocytes
 osteoblasts
 osteoclasts
 endothelial cells, form the sinusoids.

6. Aplastic anemia
Malignancies- multiple myeloma
 Infections- tuberculosis
 various forms of leukemia

8. Plasma cells arise from stem cells in the
bone marrow
Plasma cells develop from B
lymphocytes(known as B cells) cells when
foreign substances (antigens), such as
bacteria
antigen is taken up by the B cell through
receptor-mediated endocytosis and
processed

9. Pieces of the pathogen (antigenic peptides) are loaded
onto MHC II molecules, and presented on its
extracellular surface to CD4+ T cells (T helper cells).
These cause activation of the B cell
Upon stimulation by a T cell, which usually occurs in
germinal centers of secondary lymphoid organs like
the spleen and lymph nodes, the activated B cell
begins to differentiate into more specialized cells
Germinal center B cells may differentiate into memory
B cells or plasma cells

10. • plasma cell nuclei stain bluish-purple,
• Cytoplasm stain purplish-pink
• large irregular eccentric nuclei,
with prominent nucleoli close to
the center of the cell
• transparent-like, clear
cytoplasm which stained and
lost its' transparency in areas
distant to the nucleus, where
the Golgi apparatus,
endoplasmic reticulum and the
abundant mitochondria

11. plasma cells produce antibodies
give out humoral antibodies to curb down the actions
by the antigens
Both of this gives an important role in the defence
mechanism in the body

13. A bone marrow biopsy is the removal of soft tissue
called marrow from inside bone. Bone marrow is
found in the hollow part of most bones. It helps form
blood cells.
The biopsy is done using a small needle inserted into
an age appropriate area (long bone for children, flat
bone for adults).

14. Procedure of bone marrow biopsy:
a) doctor will give you a sedative
medication to make you drowsy
and relaxed
b) doctor will clean and numb the
biopsy site with an anesthetic.
c) A biopsy needle will be insert
into the bone to withdraw a
sample of bone marrow.
d) The bone marrow sample will be
sent to the laboratory for
evaluation.
e) Lastly,doctor will remove the
needle and clean and bandage
the area.

15. Bone marrow aspiration is the removal of a small
amount of this tissue in liquid form for examination.
carried out principally to permit cytological
assessment but also for immunophenotypic,
cytogenetic, molecular genetic, and other specialised
investigations.

16. Skin is numbed and needle is inserted into the bone.
Syringe is used to withdraw the liquid bone marrow.
Needle is removed.

17. Bone marrow aspiration removes a small amount of
bone marrow fluid and cells through a needle that was
inserted into the bone.
The bone marrow fluid and cells are checked for
problems with any of the blood cells made in the bone
marrow. Cells can be checked for chromosome
problems. Cultures can also be done to look for
infection.
A bone marrow biopsy removes bone with the marrow
inside to look under a microscope. The aspiration
(taking fluid) is usually done first, and then the
biopsy.

18. The bone marrow biopsy and aspiration procedure
provides information about the status and
capability for blood cell production.
Conditions that affect the marrow can affect the
number, mixture, and maturity of the cells, and can
affect its fibrous structure.

19. cultured for the presence of microorganisms such as
fungi, bacteria, or mycobacteria.

20. A bone marrow aspiration and/or biopsy may be
ordered as a diagnostic procedure when
Aplastic Anemia
Acute Leukemia
Myelodysplastic Syndrome
Chronic Myelogenous Leukemia
Myelofibrosis and Essential Thrombocythemia
Multiple Myeloma(our case)
Severe thrombocytopenia, anemia and neutropenia

21. some patients may have excessive bleeding at the
collection site or develop an infection
persistent or spreading redness or bleeding at the site
Fever
Increasing pain.
Long-lasting discomfort at the biopsy site
Penetration of the breastbone (sternum) during
sternal aspirations, which can cause heart or lung
problems
Complications related to sedation, such as an allergic
reaction, nausea or irregular heartbeats

22. Normal: Abnormal:
The marrow has normal amounts of fat, connective
tissue, and iron. Normal numbers of both mature
and immature (growing) bone marrow cells are
present
The cells in the bone marrow do not look normal
No signs of infection are seen Signs of infection are seen in the bone marrow.
No cancer cells, such as leukemia, lymphoma,
or multiple myeloma, are seen.
Cancer cells, such as leukemia, lymphoma, or
multiple myeloma, are seen
No cancer cells have spread from other cancer sites,
such as breast cancer.
Too much iron or too little iron (iron deficiency
anemia) is seen in the bone marrow.
The bone marrow has been replaced by scar tissue
There are too many or too few bone marrow cells.
The bone tissue does not look normal