Bone Marrow and Bone Tissue. Color Atlas of Clinical Histopathology.

Abstract

row aspiration. The author believes that his system produces material for study superior to those obtained by marrow aspiration and the generally used methods for marrow section. This volume is his chef d'oeuvre for promoting his system and for guiding those who would use it. The technique involves removing a cylinder of bone and marrow about 4 \m=x\18 mm. After special embedding it is cut into serial sections of 1\g=m\to 3\g=m thickness with a microtome adapted to hard sections. These methods are adequately explained and illustrated. The preparation of slides for exami¬ nation takes about six days. The quality of photomicrographs chosen and their arrangement and re¬ production are superb. Magnification is appropriate; color balance is excel¬ lent; cellular details are clear. Struc¬ tural elements of the marrow that most of us have previously taken on faith are readily distinguished. Mar¬ row blood vessels, sinusoids, fibrous meshwork, bone cells, and matrix and various hematopoietic cells, as well as their relationships to one another, are clearly distinguishable. A plastic grid can be placed over the illustrations to find particular cells or structures mentioned in the legend. This is a most useful device. While the author at times uses no¬ menclature which is not widely ac¬ cepted, his meaning is generally clear. Too often he does not tell us which findings are nonspecific and of little importance, which are suggestive of a diagnosis, and which are pathognomonic. There are clinical arenas in which this method appears clearly superior. Such conditions include bone diseases, suspected granulomatous conditions, and diseases associated with changes in small blood vessels. During the past 30 years, however, marrow aspi¬ ration and smear, using Romanowsky stains, have proven highly satisfac¬ tory as an aid in the diagnosis of disorders of erythrocytes, leukocytes, and platelets. In most such cases Burkhardt's methods would add little or nothing to the clinical diagnosis. Aplastic anemia and myelofibrosis are the major exceptions, and in these disorders conventional methods of preparing marrow sections should suffice. It is an interesting method and the results are superbly illustrated; some centers in this country should be en¬ couraged to duplicate Burkhardt's work and add independent, firsthand evaluations.