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Knowledge and understanding of the appearance of normal bone marrow (BM) and therefore normal haematopoiesis is essential for both general pathologists and specialist haematopathologists. It is only once normal cytology and histology is understood that abnormalities can be identified and defined, leading to the accurate diagnosis of pathologies seen in the BM.
The bone marrow (BM) extracellular matrix (ECM) is often inconspicuous, and hence neglected in a normal BM trephine biopsy (BMB), but it has essential functions in the homeostasis of bone and the maturation of haematopoiesis (see Chapter 2). The ECM surrounds the bony trabeculae, which are covered by osteoblasts and osteoclasts, the latter an essential component of the stem cell niche, and embeds the maturing haematopoietic cells. It is rich in hyaluronic acid, type III collagen (reticulin), fibronectin and laminin.
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