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Left panel: In acute myeloid leukemia (AML), one or more genetic mutations in a hematopoietic stem cell causes proliferation of the neoplastic clone, outcompeting the residual normal hematopoietic cells (megakaryocytes, erythroid and myeloid progenitors). In many animals, the neoplastic cells spill into blood, resulting in a marked leukocytosis, comprised primarily of tumor cells with single or multiple cytopenias (non-regenerative anemia, neut…

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…occurs is decreased bone marrow iron (seen as hemosiderin on Prussian-blue stained bone marrow smears) as iron stores are used to maintain erythropoiesis. This is associated with low ferritin (in man), normal iron and % saturation with no anemia. Since ferritin correlates weakly to iron stores in animals, this parameter should not be relied upon as a reliable indicator of bone marrow iron stores. 2. Iron-deficient erythropoiesis: Iron stores in m…

…occurs is decreased bone marrow iron (seen as hemosiderin on Prussian-blue stained bone marrow smears) as iron stores are used to maintain erythropoiesis. This is associated with low ferritin (in man), normal iron and % saturation with no anemia. Since ferritin correlates weakly to iron stores in animals, this parameter should not be relied upon as a reliable indicator of bone marrow iron stores. 2. Iron-deficient erythropoiesis: Iron stores in m…

…. Amorphous crystals or debris, however, can have a virtually identical appearance. Use of phase contrast microscopy can help in distinguishing between the two, but examination of a gram-stained drop of the urine sediment is most reliable. Lower panel: High magnification view of a gram-stained slide. A neutrophil and gram positive cocci arranged in clusters and short chains are shown (arrows: some organisms have partially or completely decolorize…

…identifiable as to source. Some could represent fragmentation of larger crystals. The pH of the urine can be a guide as to the likely nature of the amorphous crystals (e.g. amorphous phosphates are more likely in alkaline urine in small animal patients). The main issue with amorphous crystals is that they mimic bacterial cocci (and even undergo brownian movement in urine). When in doubt, perform a gram stain on urine. Amorphous crystals do not t…