All hematology fellows have a weekly Morphology Conference conducted by Dr. Mervyn L. Goldstein when they are assigned to a West Campus rotation.
Educational Purpose
To review peripheral smears; bone marrow aspirates, biopsies, and imprints; lymph node aspirates, imprints and sections; spinal, peritoneal and ascitic fluids; lung, liver, and brain imprints at a multiheaded microscope in order to review the major morphologic features of a wide variety of hematological disorders.
Principal Teaching Method
A structured curriculum was created to introduce and reinforce specific morphologic abnormalities. These sessions are case-based and provide clinical information and the slides demonstrating the morphologic abnormalities used to diagnose a wide variety of hematological disorders. The series of conferences commences with a discussion of techniques of bone marrow aspiration and biopsy, including tibial, vertebral, sternal and iliac crest punctures. Special techniques for handling and processing marrow specimens are discussed. Indications and procedures for obtaining lymph node imprints are reviewed. Imprints of other tissues, and the obtaining and processing of other body fluids in relation to hematological and malignant diseases are reviewed. The process of systematically reviewing blood smears and marrows, nomenclature, and normal elements are then discussed and demonstrated. Clinical data is presented when reviewing these specimens. Fellows are asked to describe the microscopic findings and to correlate them with the clinical data.
Most Important Educational Content
This conference provides trainees with an opportunity to refine their powers of observation and to see many hematological disorders that they might not otherwise encounter during a single year of training.
Site’s Resources
Dr. Goldstein has an extensive slide collection that includes many uncommon hematological disorders. He uses a slide collection of approximately 1000 specimens that he has accumulated since 1956. Materials studied include peripheral blood; marrow aspirates, imprints and sections; lymph node aspirates, imprints and sections; spinal, peritoneal and ascitic fluids; lung, liver, and brain imprints. Specimens may be stained with Wright stain, Giemsa, H and E, Sudan Black, potassium ferrocyanide, India ink, trichrome or silver stains, and many others. Over the course of the year, the full spectrums of hematological disorders are presented, including some diseases that are usually limited to children. The hematology division is equipped with a five-headed microscope in the Fellows room at Montefiore Moses, which is used, for this conferences.