BONE MARROW: Aspiration, Core (Trephine) Biopsy


Andy Nguyen, M.D. / UT-Medical School at Houston, Pathology/ Last Revision on: 1/28/2013


Cancer Synoptic Case Summary



_x__ Peripheral blood smear

_x__ Bone marrow aspiration

_x__ Bone marrow aspirate clot (cell block)

_x__ Bone marrow core (trephine) biopsy

_x__ Bone marrow core touch preparation (imprint)



_x__ Aspiration

_x__ Biopsy


Aspiration Site

_x__  Posterior iliac crest


Biopsy Site

_x__ Posterior iliac crest


Histologic Type

***Select one from the list at the end


Immunophenotyping (flow cytometry and/or immunohistochemistry)

___ Performed, see separate report: ___________________


Cytogenetic Studies

___ Performed, see separate report: ___________________


Fluorescence In Situ Hybridization

 ___ Performed, see separate report: ___________________


Molecular Genetic Studies

___ Performed, see separate report: ___________________







Myeloproliferative Neoplasms

___ Chronic myelogenous leukemia, BCR-ABL1 positive

___ Chronic neutrophilia leukemia

___ Polycythemia vera

___ Primary myelofibrosis

___ Essential thrombocythemia

___ Chronic eosinophilic leukemia, not otherwise specified (NOS)

___ Mastocytosis (specify type): ____

___ Myeloproliferative neoplasm, unclassifiable


Myeloid and Lymphoid Neoplasms With Eosinophilia and Abnormalities of PDGFRA, PDGFRB and FGFR1

___ Myeloid or lymphoid neoplasm with PDGFRA rearrangement

___ Myeloid neoplasm with PDGFRB rearrangement

___ Myeloid or lymphoid neoplasm with FGFR1 abnormalities


Myelodysplastic/Myeloproliferative Neoplasms

___ Chronic myelomonocytic leukemia

___ Atypical chronic myeloid leukemia BCR-ABL1 negative

___ Juvenile myelomonocytic leukemia

___ Myelodysplastic/myeloproliferative neoplasm, unclassifiable

___ Refractory anemia with ring sideroblasts associated with marked thrombocytosis


Myelodysplastic Syndromes

___ Refractory anemia

___ Refractory neutropenia

___ Refractory thrombocytopenia

___ Refractory anemia with ring sideroblasts

___ Refractory cytopenia with multilineage dysplasia

___ Refractory anemia with excess blasts

___ Myelodysplastic syndrome associated with isolated del(5q)

___ Myelodysplastic syndrome, unclassifiable

___ Refractory cytopenia of childhood


Acute Myeloid Leukemia (AML) With Recurrent Genetic Abnormalities

___ AML with t(8;21)(q22;q22); RUNX1-RUNX1T1

___ AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBFB-MYH11

___ Acute promyelocytic leukemia with t(15;17)(q22;q12); PML-RARA

___ AML with t(9;11)(p22;q23); MLLT3-MLL

___ AML with t(6;9)(p23;q34); DEK-NUP214

___ AML with inv(3)(q21q26.2) or t(3;3)(q21;q26.2); RPN1-EVI1

___ AML (megakaryoblastic) with t(1;22)(p13;q13); RBM15-MKL1

___ AML with mutated NPM1

___ AML with mutated CEBPA


Acute Myeloid Leukemia With Myelodysplasia-Related Changes (select all that apply)

___ Multilineage dysplasia

___ Prior myelodysplastic syndrome

___ Myelodysplasia-related cytogenetic abnormalities


Therapy-Related Myeloid Neoplasms

___ Therapy-related AML

___ Therapy-related myelodysplastic syndrome

___ Therapy-related myelodysplastic/myeloproliferative neoplasm


Acute Myeloid Leukemia, NOS

___ AML with minimal differentiation

___ AML without maturation

___ AML with maturation

___ Acute myelomonocytic leukemia

___ Acute monoblastic/monocytic leukemia

___ Acute erythroid leukemia

___ Acute megakaryocytic leukemia

___ Acute basophilic leukemia

___ Acute panmyelosis with myelofibrosis

___ AML, NOS#

Myeloid Proliferations Related to Down Syndrome

___ Transient abnormal myelopoiesis

___ Myeloid leukemia associated with Down syndrome


Acute Leukemias of Ambiguous Lineage

___ Acute undifferentiated leukemia

___ Mixed phenotype acute leukemia with t(9;22)(q34;q11.2); BCR-ABL1

___ Mixed phenotype acute leukemia with t(v;11q23); MLL rearranged

___ Mixed phenotype acute leukemia, B/myeloid, NOS

___ Mixed phenotype acute leukemia, T/myeloid, NOS

___ Mixed phenotype acute leukemia, NOS, rare types (specify type): _____________

___ Natural killer (NK) cell lymphoblastic leukemia/lymphoma


Other Myeloid Leukemias

___ Blastic plasmacytoid dendritic cell neoplasm


Precursor Lymphoid Neoplasms

___ B lymphoblastic leukemia/lymphoma, NOS#

___ B lymphoblastic leukemia/lymphoma with t(9;22)(q34;q11.2); BCR-ABL1

___ B lymphoblastic leukemia/lymphoma with t(v;11q23); MLL rearranged

___ B lymphoblastic leukemia/lymphoma with t(12;21)(p13;q22); TEL-AML1 (ETV6-RUNX1)

___ B lymphoblastic leukemia/lymphoma with hyperdiploidy

___ B lymphoblastic leukemia/lymphoma with hypodiploidy (hypodiploid ALL)

___ B lymphoblastic leukemia/lymphoma with t(5;14)(q31;q32); IL3-IGH

___ B lymphoblastic leukemia/lymphoma with t(1;19)(q23;p13.3); E2A-PBX1 (TCF3-PBX1)


___ T lymphoblastic leukemia/lymphoma


Mature B-Cell Neoplasms

___ Chronic lymphocytic leukemia/small lymphocytic lymphoma

___ B-cell prolymphocytic leukemia

___ Splenic B-cell marginal zone lymphoma

___ Hairy cell leukemia

___ Splenic B-cell lymphoma/leukemia, unclassifiable

___ Splenic diffuse red pulp small B-cell lymphoma

___ Hairy cell leukemia-variant

___ Lymphoplasmacytic lymphoma

___ Plasma cell myeloma

___ Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)

___ Follicular lymphoma

___ Mantle cell lymphoma

___ Diffuse large B-cell lymphoma (DLBCL), NOS

___ T cell/histiocyte-rich large B-cell lymphoma

___ Primary cutaneous DLBCL, leg type

___ Epstein-Barr virus (EBV)-positive DLBCL of the elderly

___ DLBCL associated with chronic inflammation

___ Lymphomatoid granulomatosis

___ Anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma

___ Plasmablastic lymphoma

___ Large B-cell lymphoma arising in HHV8-associated multicentric Castleman disease

___ Burkitt lymphoma

___ B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma

___ B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma

___ B-cell lymphoma, NOS

___ Other (specify): ____________________________


Mature T- and NK-cell Neoplasms

___ T-cell lymphoma, subtype cannot be determined (Note: not a category within the WHO classification)

___ T-cell prolymphocytic leukemia

___ T-cell large granular lymphocytic leukemia

___ Chronic lymphoproliferative disorder of NK cells

___ Aggressive NK-cell leukemia

___ Adult T-cell leukemia/lymphoma

___ Extranodal NK/T-cell lymphoma, nasal type

___ Enteropathy-associated T-cell lymphoma

___ Hepatosplenic T-cell lymphoma

___ Mycosis fungoides

___ Peripheral T-cell lymphoma, NOS

___ Angioimmunoblastic T-cell lymphoma

___ Anaplastic large cell lymphoma, ALK-positive

___ Anaplastic large cell lymphoma, ALK-negative


Hodgkin Lymphoma

___ Nodular lymphocyte predominant Hodgkin lymphoma

___ Classical Hodgkin lymphoma


Histiocytic and Dendritic Cell Neoplasms

___ Histiocytic sarcoma

___ Langerhans cell histiocytosis

___ Langerhans cell sarcoma

___ Interdigitating dendritic cell sarcoma

___ Follicular dendritic cell sarcoma

___ Disseminated juvenile xanthogranuloma

___ Histiocytic neoplasm, NOS


Posttransplant Lymphoproliferative Disorders (PTLD)

Early lesions:

___ Plasmacytic hyperplasia

___ Infectious mononucleosis-like PTLD

___ Polymorphic PTLD

___ Monomorphic PTLD (B- and T/NK-cell types)

Specify subtype: ________________________

___ Classical Hodgkin lymphoma type PTLD


___ Other (specify): ____________________________