Overview
Hematopoietic sites change during development and concentrate in axial marrow in adults.
Classification
| Stage | Site | Bench note |
|---|---|---|
| Embryonic | Yolk sac | Historical / educational |
| Fetal | Liver, spleen, marrow | Age-specific intervals |
| Adult | Axial marrow | Fatty conversion peripherally |
| Extramedullary | Spleen, liver | NRBCs, teardrop cells, correlate |
Morphologic Features
NRBCs and teardrop poikilocytes may suggest marrow stress, confirm on smear.
Laboratory Characteristics
- Pediatric reference intervals mandatory
- Marrow biopsy site documentation on reports
Reference Intervals
Age-specific CBC and marrow cellularity references per institutional verification.
Clinical and Laboratory Significance
- Extramedullary hematopoiesis, marrow correlation often required
Differential Considerations
Neonatal low Hgb may be physiologic, use age-matched data.
Comparison Tables
Sampling sites (introductory)
| Site | Common adult use |
|---|---|
| Posterior iliac crest | Routine aspiration/biopsy |
| Sternum | Operator-dependent; institutional protocol |
| Vertebral bodies | Imaging correlation; not routine bench sampling |
Classification Frameworks
Not applicable to normal site physiology.
Laboratory Notes
- Fatty marrow conversion is age-related, affects cellularity interpretation.
References
Authoritative textbooks, guidelines, and reviews supporting this reference entry. Verify reference intervals, critical limits, and reflex criteria against institutional protocols and current guideline editions.
Textbooks
- McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Elsevier; 2021.
- Rodak BF, Carr JH. Rodak's Hematology: Clinical Principles and Applications. 6th ed. Elsevier; 2020.
- Hoffbrand AV, Moss PAH, Pettit JE. Essential Haematology. 8th ed. Wiley-Blackwell; 2019.
- McKenzie SB, Williams JL. Clinical Laboratory Hematology. 4th ed. Pearson; 2022.
Professional Monographs
- Barnes PW, McFadden SL, Machin SJ, Doig K. Laboratory Hematology Practice. Wiley-Blackwell; 2012.
CLSI and Professional Guidelines
- Clinical and Laboratory Standards Institute. Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Standard. CLSI document EP28-A3c. CLSI; 2010.
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