Diagnostic importance of blood and bone marrow study in blood cancers.

We know bone marrow cells have distinctive cytological appearances that reflect the lineage and stage of maturation which these features may be disordered in disease specifically. That’s why, HSC mainly reside in BM and special environment or niche orchestrates HSC fate including their quiescence and proliferation cells in normal and abnormal situations extrinsically. On the one hand, in distinguishing a reactive lymphoid proliferation from a lymphoproliferative disorder requires to lymphocyte morphology for pleomorphic lymphocyte vs. a monomorphic population with a latter favoring a lymphoid malignancy. On the other hand, the clumps of abnormal cells could indicate the infiltration of metastatic tumor. Hence, the manual differentiation is key which means whether a myeloid or lymphoid leukocytosis is favored, the presence of increased blasts should prompt bone marrow examination with providing additional necessary help studies. In this case, along with correct enumeration of blasts and blast equivalent, we should be checked immature granulocytes, basophils and eosinophils as well as distinguishing dysplasia to identify myelodysplastic syndrome or leukemia as well.