ABSTRACT
Bone marrow aspiration and trephine biopsies are commonly used procedures in clinical practice. The practice of making a clot section by using the leftover blood from the bone marrow aspirate material is not a commonly followed practice across centers. A clot section has the advantage of studying the added material with an increased possibility of detecting focal lesions such as myeloma, lymphoma, granuloma, and metastasis in the bone marrow. Bone marrow aspirate, trephine biopsy, and clot section were compared for the detection of focal lesions in a series of 5 patients, 3 of who presented with a history of fever and 2 were already diagnosed cases of Hodgkin lymphoma. Focal lesions were detected in the 5 cases in the clot section alone, whereas bone marrow aspirate and trephine biopsy did not show any focal lesion. Granulomatous infiltration was detected in 3 patients, and lymphomatous infiltration was detected in 2 patients in the clot section, whereas bone marrow aspirate and trephine biopsy were negative for any focal lesion in all 5 cases. A clot section is particularly useful in the detection of bone marrow lesions with a focal distribution. Hence, it must be studied alongside bone marrow aspirate smears, touch smears, and trephine biopsy to increase the diagnostic yield.
ABSTRACT
Introduction: Inspection of the bone marrow is considered oneof the most valuable diagnostic tool to evaluate hematologicmalignancies. This study compares all three techniques ofbone marrow aspiration (BMA), bone marrow imprint (BMI)and bone marrow biopsy (BMB) in morphological diagnosisof hematological malignancies.Material and methods: The study was conducted on 63selected cases of various hematological malignancies. Onlythose cases in which bone marrow examination was done byusing all the three techniques were included in the study.Results: Out of total 63 cases,53 cases were diagnosed onbone marrow aspirate smears with diagnostic accuracy of84.12%, 60 cases were diagnosed on bone marrow imprintsmears with diagnostic accuracy of 95.23% and all 63 caseswere diagnosed on bone marrow biopsy with diagnosticaccuracy of 100%.Conclusion: It is concluded that bone marrow imprintsare equally useful as bone marrow biopsy in diagnosinghematological malignancies. Imprint cytology shouldtherefore be a standard practice for evaluating bone marrow incases of hematological malignancies.
ABSTRACT
Background: Bone marrow examination is useful in the diagnosis of both hematological and non-hematological disorders. The two most important techniques used for the diagnosis of hematological disorders are bone marrow aspiration and trephine biopsy which are complementary to each other. The present study is to evaluate the findings of bone marrow aspiration & trephine biopsy and their cytological and histological patterns in various hematological disorders. The aim of the study is to evaluate the clinical profile, spectrum, cytological and histological pattern of various hematological disorders reported in bone marrow aspiration and trephine biopsy respectively. Methods: It was a cross-sectional study design with 105 patients who underwent bone marrow examination for evaluation of hematological disorders in the Department of pathology, Andhra Medical College during the period of 2012 to 2014. Results: Among 105 cases studied, age of patients ranged from 1 to 68 yrs with mean age of 32.4 yrs and male predominance (1.5:1). Most of the patients presented with fever, shortness of breath, Easy fatigability and generalized weakness. The commonest physical findings were pallor followed by splenomegaly & hepatomegaly and in hematological parameters predominantly pancytopenia. Bone marrow aspiration was diagnostic in 53(50%) cases and trephine biopsy was diagnostic in 52(50%) cases. Anemias (50%) and leukemias (16%) are most common hematological disorders. Among the anemias, megaloblastic anemia is the most common (40%) cause of hematological non-malignancies. Among leukemias, acute myeloid leukemias are common cause of hematological malignancies. Conclusion: The present study showed the usefulness of bone marrow aspiration and trephine biopsy in evaluation of the bone marrow in routine haematological disorders and also for understanding disease progression, for diagnosis and therapeutic evaluation. These are also helpful in planning further investigation and management.
ABSTRACT
Diagnostic Assessment of bone marrow aspirate particle smears, imprints and biopsy sections was done on 10 Non- Haematological disorders. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity, metastatic tumours and fibrosis . Bilateral trephine biopsy was conducted wherever necessary. Touch imprints were useful for studying cell morphology, where aspiration yielded dry tap.All the three procedures of bone marrow aspiration, trephine biopsy and touch imprints were found to be complementary to each other and superiority of one method over the other depended on the specific disease process.
ABSTRACT
Diagnostic Assessment of bone marrow aspirate particle smears, imprints and biopsy sections was done on 40 haematological disorders. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity and fibrosis.Bilateral trephine biopsy was conducted wherever necessary.Bone marrow aspiration was the most effective method for studying morphological details and was able to diagnose most of the cases except the 2 cases of myelofibrosis which yielded dry tap for which trephine biopsy was diagnostic.Trephine biopsy was also found to be superior for staging of lymphomas and to study the ALIP in MDS.Touch imprints were useful for studying cell morphology, where aspiration yielded dry tap.All the three procedures of bone marrow aspiration, trephine biopsy and touch imprints were found to be complementary to each other and superiority of one method over the other depended on the specific disease process.
ABSTRACT
Context: Bone marrow (BM) biopsy is an integral part of staging work-up for non-Hodgkin lymphoma (NHL). Aims: To study the characteristics of BM involvement in NHL with respect to incidence, histologic pattern and morphology of infiltration and its discordance with the histology of primary anatomic site. Settings and Design: Forty-nine cases of NHL in which BM biopsy was performed for staging were included in this study, the primary site being classified according to the WHO classification for NHL. Materials and Methods: A prospective study of 49 cases was conducted. Bilateral BM biopsy was obtained from the posterior superior iliac spine. The biopsies were fixed in 10% buffered formalin solution and decalcified using 10% formal - formic acid for 4 - 6 h followed by routine processing. The serial sections were stained by hematoxylin and eosin and reticulin stains. Results: BM biopsy showed involvement by lymphoma in 27 cases (55.10%). Unilateral positivity was found in four cases (14.81% cases). The overall incidence of marrow involvement by NHL was 55.1%. The incidence of involvement was higher in T-cell lymphomas when compared with B-cell lymphomas and predominant pattern of involvement was mixed. Diffuse large B-cell lymphomas had the lowest incidence in all the B-cell lymphomas. A discordant histology between BM and primary anatomic site was found in 29.63% (8/27) of the cases, where it was seen more in follicular lymphomas and diffuse large B-cell lymphomas. Conclusions: Critical examination of BM biopsies can increase the diagnostic accuracy, thereby contributing to the prognosis and appropriate treatment modalities.