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The page below is a sample from the LabCE course Bone Marrow Aspiration: Normal Hematopoiesis and Basic Interpretive Procedures. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Cellularity and Additional Information

Depending on the institution and laboratory protocol, comments on the degree of cellularity, presence of megakaryocytes, and presence of tumor cells may be added to the report by the technologist who performs the differential count. The terms used to describe these features will be determined by the hematopathologist.

Cellularity is usually rated as normal, increased, or decreased. However, other terms may be used as well, such as "slightly decreased," "markedly decreased," or "markedly increased," etc. When spicules/fragments are not present, terms like "hemodilute" can be used to note very dilute bone marrows or, it may simple be marked as "not evaluable".

For megakaryocytes the common terms of quantitation may be:

  • None Seen
  • Rare
  • Decreased
  • Present
  • Normal
  • Increased

The presence of tumor cells should be noted as well as the slide or site in which they were observed.

The top image on the right demonstrates a bone marrow that is markedly hypocellular. Only fragments of the bone marrow structure are present, with very few bone marrow precursor cells observed. Compare this to the bottom image that depicts a bone marrow that is normocellular.