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V.B.001 Increased Iron Aggregates

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V.B.001

Increased iron aggregates. Marrow. Prussian blue stain. Several macrophages engorged with iron are noted. The frequency of iron aggregates is greater than seen in normal marrow. Marrow iron is contained in two proteins: hemosiderin and ferritin. Prussian blue stains hemosiderin iron and macrophage iron is principally hemosiderin. In iron deficient states, loss of marrow storage iron in hemosiderin and ferritin is proportionately similar and thus staining for hemosiderin is a reasonable measure of storage iron.

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V.B.002 Increased Iron Aggregates

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V.B.002

Increased iron aggregates. Marrow. Prussian blue stain. The frequency of iron aggregates is greater than seen in normal marrow. Marrow iron is contained in two proteins: hemosiderin and ferritin. Prussian blue stains hemosiderin iron and macrophage iron is principally hemosiderin. In iron deficient states, loss of marrow storage iron in hemosiderin and ferritin is proportionately similar and thus staining for hemosiderin is a reasonable measure of storage iron.

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V.B.003 Marrow Iron, Unstained

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V.B.003

The presence of marrow iron can be determined in unstained marrow samples by the golden brown refractile appearance of hemosiderin aggregates. This is demonstrated in this image of an unstained film of the mixed-fat layer removed from a centrifuged marrow aspirate. Note the increased iron (frequent hemosiderin aggregates) evident in this sample.

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V.B.004 Marrow Iron

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V.B.004

Marrow Iron. Marrow films. Prussian blue stains. (A) Absent marrow iron in a case of iron deficiency. No evidence of the blue reaction product indicative of marrow iron stores.(B) Intense staining of macrophage iron (blue reaction product in cytoplasm) in a case of lead poisoning. Although Prussian blue stain preferentially stains only one form of storage iron-proteinate, that is hemosiderin but not ferritin, its reactivity is a good assessment of marrow iron stores because marrow storage iron accumulation or loss occurs by parallel changes in both storage forms.

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