Stanford Hematopathology (Bone Marrow) Rotation

The AP hematopathology rotation is also referred to as the bone marrow/wet heme rotation and is staffed by 1-2 residents each month.  On this service you will learn basic bone marrow and peripheral blood morphology and pathology for both pediatric and adult populations.  The attendings usually change each week so you will get the opportunity to work with four of our very experienced hematopathologists.  You’ll become accustomed to integrating different sources of information as bone marrow core biopsies are usually accompanied by peripheral blood smears and aspirate smears.  In addition, some cases will have flow cytometry and cytogenetic studies, providing you with the opportunity to learn about tests performed in the other sections of the clinical pathology laboratory! 
You’ll also learn some new geography, as the bone marrow reading room is located downstairs in the clinical lab.  Peripheral blood and aspirate smears can be picked up in special heme, which is also located in the clinical lab near the reading room.  Core biopsies are processed with the surgical pathology specimens and can be picked up in surgical pathology next to hot seat each morning before sign-out.  Flow cytometry is done offsite at Hillview, where the CP resident will pick appropriate panel antibodies for each case.  The plots are then scanned and can be accessed on the departmental computer drive. 
A basic day on hemepath starts with sign-out of cases from the day before starting at around 9:30.  After sign-out the resident will order appropriate stains/studies which may included IPOX on the core (through PowerPath), special stains on the aspirate (through special heme) or additional panels for flow (need to be faxed to flow cytometry at Hillview).  You will then dictate your cases (a template will be provided for you) using the priority specimen option (work type #5 on Dictaphone).  Dictations will usually come back later that afternoon and can then be edited and sent to your attending.  While you are waiting for dictations to return you can look up the clinical history and pertinent information (ie. prior flow immunophenotype) for the next day cases as they are accessioned and put into your electronic box.  Ideally you can also preview the next day’s peripheral blood and aspirate smears, however, sometimes the service will be extremely busy and you will not have enough time to preview.  While this rotation may be overwhelming initially, once you become comfortable with the work flow you’ll learn a huge amount.  Some residents come in Sunday evening to pre-dictate clinical histories for the following day, but you can also choose to come in early Monday.  So your weekend duties are up to you.

Stanford Hematopathology

Daniel Arber, M.D.
Susan Atwater, M.D.
Bertil Glader, M.D. Ph.D.
Dita Gratzinger, M.D. Ph.D.
Marissa Juntilla, M.D., Ph.D.
Yaso Natkunam, M.D. Ph.D.
Robert Ohgami, M.D., Ph.D.
Brent Tan, M.D., Ph.D. 
Roger Warnke, M.D.
Gerlinde Wernig, M.D.

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