Correspondence on: A rare complication of bone marrow aspiration and trephine biopsy: Staphylococcus aureus osteomyelitis and septicaemia

Pancytopenia is commonly reported in clinical hematology practice. Due to its varied marrow pathology and underlying ailments, diagnosis is often misleading and delayed. Bone marrow examination would provide a comprehensive diagnosis of both blood and bone marrow, since aspirate investigates the cytological morphology and biopsy evaluates the cellularity, architecture, and compact marrows.To compare bone marrow aspiration and trephine biopsy results in the diagnosis of pancytopenia, and to determine the sensitivity and specificity of aspirate examination in pancytopenia diagnosis.This prospective study was conducted at a tertiary care hospital from July 2014 to June 2016. A total of 320 samples were received at the department of pathology for bone marrow examination (aspirate and biopsy). Romanowsky (Leishman) stain was used to investigate aspirate samples. All biopsy samples were processed into 3-5 μ blocks and stained using hematoxylin and eosin after decalcification with 5.5% EDTA. Data analysis was performed using SPSS19.Pancytopenia constituted 56 (18.7%) cases with the mean age of 41.79 years. Of the total pancytopenia cases, hematological disorders constituted 50 (89.3%) cases and 6 (10.7%) were non-hematological cases. Aspirate and biopsy diagnosis positively correlated in 76.79% of cases. A 100% sensitivity and specificity of aspirate diagnosis was observed in, acute myeloid leukemia, hypersplenism, myelodysplastic syndrome, megaloblastic anemia, hematological malignancy in remission and negative for lymphoma infiltrate. Aspirate had no role in diagnosis of uremic osteodystrophy and myelofibrosis, whereas leishmaniasis was diagnosed on aspirate alone.Pancytopenia includes multiple underlying ailments which requires a differential diagnosis approach. Combining both aspirate and biopsy for diagnosis would benefit the patient in prognosis as they are complementary to each other.

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Comparison of bone marrow aspiration cytology with bone marrow trephine biopsy histopathology: An observational study

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_117_16 ◽

2017 ◽

Vol 9 (03) ◽

pp. 182-189

Author(s):

Meenu Gilotra ◽

Monika Gupta ◽

Sunita Singh ◽

Rajeev Sen

Keyword(s):

Bone Marrow ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Final Diagnosis ◽

Trephine Biopsy ◽

Additional Advantage ◽

Hematological Disorders ◽

Bone Marrow Trephine ◽

Bone Marrow Trephine Biopsy ◽

Underlying Disorder

Abstract INTRODUCTION: Bone marrow examination is a useful investigative tool for the diagnosis of many hematological and nonhematological disorders. Bone marrow aspiration (BMA) provides information about the numerical and cytological features of marrow cells, whereas bone marrow trephine biopsies (BMB) provide excellent appreciation of spatial relationships between cells and of overall bone marrow structure. We conducted this study with the objective of comparing the accuracy of BMA with BMB in the diagnosis of various hematological disorders. MATERIALS AND METHODS: Both BMA and BMB were performed on a total of 130 cases and a comparative evaluation was performed in 100 cases to see the complementary role of both the procedures. However, 30 cases were excluded due to inadequate BMA, BMB, or both. Immunohistochemistry (IHC) was employed whenever required. RESULTS: In our study of 100 cases, 87% of cases were confirmed on bone marrow biopsy and in remaining 13% of cases final diagnosis was achieved with the help of other ancillary investigations. These cases were excluded for calculation of concordance rate between BMA and BMB. The concordance and disconcordance rate between BMA and BMB was 72.4% and 27.6%, respectively. CONCLUSION: BMA cytology and trephine biopsy histopathology complement each other and the superiority of one method over the other depended on the underlying disorder. Furthermore, application of ancillary techniques such as flow cytometery and IHC proved to be an additional advantage in further typing of various diseases.

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Bone marrow trephine biopsy in Haematological diseases: a study of 53 cases

Journal of Dhaka Medical College ◽

10.3329/jdmc.v22i2.21544 ◽

2015 ◽

Vol 22 (2) ◽

pp. 207-210

Author(s):

Hazera Khatun ◽

Salma Afrose ◽

Mohiuddin Ahmed Khan ◽

Tasneem Ara ◽

Mohammad Sirajul Islam ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Involvement ◽

Bone Marrow Aspiration ◽

Polycythaemia Vera ◽

Safe Procedure ◽

Trephine Biopsy ◽

Lymphoid Aggregate ◽

Medical College ◽

Bone Marrow Trephine Biopsy ◽

Adults And Children

Bone marrow aspiration (BMA) and biopsy (BMTB) are important investigations for diagnosis of haematolgical malignancies and non-malignant diseases both in adults and children. BMA and BMTB are complementary and if both are done a comprehensive analysis of bone marrow involvement is possible. 53 cases of BMTB were studied in order to underscore the indications and importance of BMTB. BMTB was done to determine cellularity in aplastic anaemia (AA) (33.96%, n=18) and in cases of failure of aspiration (32.08%, n=17). Failure of aspiration was attributable to bone marrow (BM) fibrosis (76%, n=13) due to acute leukaemia (35.30%, n=6) and myelofibrosis (43.17%, n=7). BMTB upstaged non Hodgkins lymphoma (NHL) from IIIB to IVB in 22.22% cases. 1 case of AA showed focal lymphoid aggregate which later evolved into acute lymphoblastic leukaemia (ALL). BMTB is a safe procedure and increased bleeding was noted only in a case of polycythaemia vera. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21544 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 207-210

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