Appearance of Bone Marrow Smears With Necrotic Tumor Cells

Bone marrow smears of necrotic tumor cells stained with Romanowsky dyes frequently have a definite reddish color that contrasts so strikingly with the blue color of normal marrow that necrosis may be suspected from gross examination. The bone marrow cells appear "smudged" and are difficult to identify on microscopic examination. Commonly, only a small amount of material is obtainable by ordinary needle aspiration of bone marrow containing necrotic tumor, and all of it is used to make smears. It is therefore important to recognize that bone marrow smears with a reddish gross appearance and in which the cells appear distorted and are difficult to identify may represent necrotic tumor and not an artifact produced by poor techniques.