scholarly journals Staining of bone marrow aspiration slides: novel immediate staining Vs EDTA–stored samples

2018 ◽  
Vol 6 (6) ◽  
Author(s):  
Asfa Zawar ◽  
Shahzad Ali Jiskani ◽  
Maryam Zulfiqar ◽  
Aliena Sohail ◽  
Asma Mustafa ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Bone Marrow Aspirate ◽  
Controlled Trial ◽  
Bone Marrow Aspiration ◽  
P Value ◽  
Trephine Biopsy ◽  
Medical Sciences ◽  
Hematoxylin And Eosin

Background: Bone Marrow Biopsy is used as an intervention to diagnose certain hematological and systemic diseases as an adjunct to routine laboratory investigations. The procedure includes getting an aspirate and a trephine biopsy. Slides/Smears are prepared from the aspirate and touch imprints along with Hematoxylin and Eosin (H and E) stained sections are prepared from the trephine. Traditionally the slides from the aspirate have been prepared directly (without anticoagulants) and examined along with the trephine biopsy sections to reach a diagnosis. EDTA (Ethylene Diammine Tetra Acetate) preserved specimen can also be used to make slides of the aspirate. Objective: To compare two methods of bone marrow aspirate preparation. Design of study: Randomized controlled trial. Place of study: Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad Materials and methods: Patients coming to the Department of Pathology for bone marrow biopsy had their samples taken. Half of each sample was used to make direct smears and the other half was preserved in EDTA i.e. the purple top vials. Slides were made at the end of the procedure by the preserved sample and then the two were stained by the same person and procedure (Wright stain) and examined for any differences in quality. SPSS version 21.2 was used to analyze the data. Results: A total of 132 was taken.77 (58.3%) were males and 55(41.7%) were females. 50(37.9%) were adults and 82(62.1%) were children. P–value was found to be 0.81392 which was non-significant proving the fact that the 2 techniques are comparable. Conclusion: EDTA preserved bone marrow aspirate can be used to prepare slides at the end of the whole procedure without compromising the quality of the smears and result interpretation.

A comparative study of bone marrow aspirate with trephine biopsy in pancytopenia disorders

2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK
Keyword(s):  
Bone Marrow ◽  
Sensitivity And Specificity ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Trephine Biopsy ◽  
Hematological Disorders ◽  
Hematoxylin And Eosin

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.

A New Rotary Powered Device for Bone Marrow Aspiration and Biopsy Yields Superior Specimens with Less Pain: Results of a Randomized Clinical Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1529-1529 ◽  
Author(s):  
Ronan Swords ◽  
Javier Anguita ◽  
Russell A. Higgins ◽  
Andrea Yunes ◽  
Michael Naski ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Research Funding ◽  
Bone Marrow Aspiration ◽  
Morbidity And Mortality ◽  
Procedure Time ◽  
Medullary Bone ◽  
Biopsy Device ◽  
The Mean

Abstract Abstract 1529 Introduction: The importance of bone marrow aspiration and biopsy in the evaluation of hematopoietic and non-hematopoietic disorders is well established. However, this technique is associated with morbidity and mortality risks.1 Recently, a battery-powered bone marrow biopsy system was developed to allow operators to safely, quickly and efficiently access the marrow space. We previously evaluated this device in swine models and in patients needing routine hematology outpatient evaluation.2 In the current study we compared the powered device to the traditional manual technique by relatively assessing pain scores, procedure times, biopsy capture rates, quality of material retrieved, safety and operator satisfaction. Methods: Two large academic medical centers participated in this trial (San Antonio, TX and Madrid, Spain). The study protocol was approved by each center's institutional review board. Adult patients requiring bone marrow biopsies were considered for the study. Following informed consent, patients were randomized to have procedures using a manual biopsy device (T-handle Jamshidi bone marrow biopsy and aspiration set, Cardinal Health, Dublin, OH) or the Powered device (OnControl 11 gauge/102mm Bone Marrow Biopsy System, Vidacare Corporation, Shavano Park, TX). After infiltration of the skin and medullary bone with local anesthesia, a visual analog scale (VAS) pain score was recorded immediately following skin puncture and once again at the end of the procedure for each patient. Procedure time was measured from skin puncture to core specimen ejection from the needle. Pathologic assessment of 30 randomized samples was carried out. Operator satisfaction with devices was measured on a scale of 0–10, with 10 as the highest rating. Statistics were calculated using t-test and chi-square, with an alpha-level of 0.05. Results: Five operators from 2 sites enrolled 50 patients (Powered, n=25; Manual, n=25). Of those patients, 58% were male and 42% were female; and had a mean age of 56.0±18.0 years. The mean height was 167.5 ± 10.5cm and the mean weight was 78.7 ± 22.7kg. Forty percent were lymphoma patients—the largest diagnostic group. Between patient groups, there were no significant differences in the means for these variables. See Table below for quantitative results, including pathology analysis. For the pathology qualitative analysis, there was no difference between groups for hemorrhage, clot/particle spicules, or smear spicules. Conclusions: Results of this trial suggest that the use of a Powered bone marrow biopsy device significantly reduces needle insertion pain. While not reflected in the results, overall pain may be better tolerated due to the important difference in procedure time. Moreover, the superior size and overall quality of core specimens retrieved by the Powered device provides more material for pathologic evaluation, thereby increasing diagnostic yield and reducing the need for repeat procedures. Cohesiveness of the medullary bone sampled was comparable for both techniques; however, the Powered system was less likely to recover non-hematopoietic tissue (e.g. cortical bone and soft tissue). Artifact was slightly more common with the Powered device (aspiration, hemorrhage and crush) but this did not impact on the diagnostic quality of the sample. No differences in safety data were noted for either technique and operator satisfaction favored the Powered device. 1. Bain BJ. Bone marrow biopsy morbidity and mortality. British Journal of Haematology 2003;121:949-51. 2. Swords RT, Kelly KR, Cohen SC et al. Rotary powered device for bone marrow aspiration and biopsy yields excellent specimens quickly and efficiently. J Clin Pathol 2010;63:562-5. Disclosures: Swords: Vidacare Corporation: Research Funding. Anguita:Vidacare Corporation: Research Funding. Kelly:Vidacare Corporation: Research Funding. Philbeck:Vidacare Corporation: Employment. Miller:Vidacare Corporation: Employment, Equity Ownership. Brenner:Vidacare Corporation: Research Funding.

scholarly journals Role of the Bone Marrow Examination among Undifferentiated Fever in Tropics

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Decision Making ◽  
Bone Marrow Aspiration ◽  
Clinical Decision ◽  
Bone Marrow Examination ◽  
Diagnostic Tools ◽  
P Value ◽  
Highly Sensitive

Background: Bone marrow aspiration and biopsy is one of the most important diagnostic tools for evaluation of undifferentiated fever. The positivity yield of these samples is highly specific that provides additional evidence for clinical decision making among the undifferentiated febrile cases. With this background we evaluated the bone marrow results of undifferentiated febrile cases for the last five years at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. The objective of the study was to measure the sensitivity of the bone marrow investigations among undifferentiated febrile cohort. Methods: A retrospective study was performed from January 2010 till December 2014 evaluating bone marrow reports. Completed request forms and the histopathological reports of the bone marrow specimens were reviewed. Statistical data was analyzed using SPSS 17 and p-value of <0.05 was considered significant. Results: Over the half decade 319 specimens were collected for bone marrow biopsy out of that 27% were requested for undifferentiated fever. The mean and median age of the biopsy performed patients was 35 and 31 years respectively. Among all biopsy samples 59% was adequate for evaluation however among the undifferentiated febrile cases biopsy samples only 45% was adequate for evaluation. The sensitivity of bone marrow biopsy was 34%. There were 714 bone marrow aspiration samples of that 84% was adequate for evaluation. The most common etiological diagnosis for the undifferentiated fever from the marrow evaluation was visceral leishmaniasis (53%). The sensitivity of the bone marrow aspiration and aspiration or biopsy for visceral leishmaniasis was 95% and 98% respectively. (p value 0.03) Conclusion: Bone marrow aspiration is highly sensitive and specific for the diagnosis of visceral leishmaniasis among the undifferentiated fever at tropics in Nepal.

Midazolam in conjunction with local anaesthesia is superior to Entonox in providing pain relief during bone marrow aspirate and trephine biopsy

2008 ◽  
Vol 61 (9) ◽  
pp. 1051-1054 ◽  
Author(s):  
G Chakupurakal ◽  
J Delgado ◽  
E Nikolousis ◽  
S Pitchapillai ◽  
D Allotey ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Respiratory Function ◽  
Bone Marrow Aspirate ◽  
Controlled Trial ◽  
Patient Experiences ◽  
Trephine Biopsy ◽  
Effective Pain Relief ◽  
Randomised Controlled

Aim:To compare intravenous titrated midazolam 5–10 mg and inhaled Entonox in addition to local anaesthesia in order to identify which agent provides optimum pain relief.Methods:Randomised, controlled trial. 49 patients were recruited, of which 46 were evaluable. 24 and 22 patients were recruited into the Entonox and midazolam arms, respectively. Patient experiences as well as staff observations were recorded with questionnaires after recovery from the procedure and 24 hours later.Results:45% and 59% of the patients in the midazolam arm could recollect the procedure after 15 minutes and 24 hours, respectively, compared to 96% and 88% who received Entonox. Midazolam provided a more comfortable experience (p<0.01) and improved pain relief (p = 0.01) compared to Entonox immediately after the procedure; this further improved when recalled 24 hours later. Nausea, dizziness and hallucinations were observed with both treatments, but dizziness was significantly more frequent with Entonox (p = 0.048). Clinically relevant respiratory depression (O2 saturation <90%) occurred in 19% of patients in the midazolam arm; sedation was reversed with flumazenil.Conclusion:Midazolam in conjunction with local anaesthesia provides rapid and reversible sedation as well as effective pain relief during bone marrow biopsy, and is superior to Entonox; however, care must be taken to monitor respiratory function.

A study of clinico-haematological profiles of pancytopenia in children

2008 ◽  
Vol 38 (4) ◽  
pp. 241-243 ◽  
Author(s):  
V Gupta ◽  
S Tripathi ◽  
V Tilak ◽  
B D Bhatia
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Megaloblastic Anaemia ◽  
Trephine Biopsy ◽  
Medical Sciences ◽  
Common Cause ◽  
Detailed History ◽  
The Third ◽  
Kala Azar ◽  
Haematological Profile

We report on the clinico-haematological profile of pancytopenia in children from the Departments of Pediatrics and Pathology, Institute of Medical Sciences, Banaras Hindu University, India, over a period of 30 months. Pancytopenia was defined as: haemoglobin <10 g/dL, absolute neutrophil count 1.5 × 109/L and platelet count <100 × 109/L. A detailed history, clinical examination and haematological parameters were recorded. Bone marrow aspiration and trephine biopsy were carried out in all cases. One hundred and five cases aged 1.5–18 years, with a mean age of 8.6 years, were included in the study. Aplastic anaemia was the most common cause of pancytopenia (43%) followed by acute leukaemia (25%). Infections were the third most common cause of pancytopenia of which kala azar was the most common. Megaloblastic anaemia was seen in 6.7%.

COMPARATIVE EVALUATION OF BONE MARROW ASPIRATION AND TREPHINE BIOPSY IN PANCYTOPENIA IN VARIOUS HEMATOLOGICAL DISEASES

2021 ◽  
pp. 33-35
Author(s):  
Ajit Kumar ◽  
Monika Girdhar ◽  
Karandeep Singh ◽  
Sarvek Bajaj ◽  
Sumit Kamboj ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Diagnostic Yield ◽  
Bone Marrow Aspiration ◽  
Diagnostic Procedures ◽  
Bone Marrow Examination ◽  
Trephine Biopsy ◽  
Hematological Disorders ◽  
Hematological Diseases ◽  
Discordance Rate

Bone marrow examination is an important tool for the diagnosis of various hematological disorders. It involves the use of bone marrow aspiration (BMA) and bone marrow biopsy (BMB). To compare concordance and discordance rate between bone Objectives: marrow aspiration and trephine biopsy ndings in making etiological diagnosis in pancytopenia patients. A cross Material And Methods: sectional prospective study was conducted in department of pathology MAMC, Agroha on 36 cases of pancytopenia to compare the ndings of bone marrow aspiration and bone marrow biopsy. The overall concordance and discordance rate between BMA and BMB wa Results: s 63.8% and 36.2% respectively. Conclusion: It was concluded in our study that BMA and BMB are important, useful complementary diagnostic procedures which gives a higher diagnostic yield when performed simultaneously.

scholarly journals Bone marrow profile in hematological disorders: an experience from a tertiary care centre

2018 ◽  
Vol 5 (3) ◽  
pp. 608 ◽  
Author(s):  
Nusrat Bashir ◽  
Bilal Musharaf ◽  
Ruby Reshi ◽  
Tazeen Jeelani ◽  
Danish Rafiq ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Malarial Parasite ◽  
Deficiency Anemia ◽  
Trephine Biopsy ◽  
Tertiary Care Centre ◽  
Hematological Disorders ◽  
One Year

Background: Bone marrow aspiration and trephine biopsy are two most important techniques which are complementary for diagnosing both neoplastic and non- neoplastic haematological diseases. The present study was conducted in the department of pathology to compare the role of bone marrow aspirate and trephine biopsy for diagnosing the haematological diseases.Methods: The study was conducted in the department of pathology government medical college Srinagar over a period of 2 years from Feb 2016 to Jan 2018. The study was one-year retrospective and one year prospective. Bone marrow aspiration was done in 626 cases out of which biosy was done in 300 cases.Results: Out of the selected 300 cases were both aspiration and trephine biopsy were available, diagnostic material on bone marrow aspirate was adequate in 288 cases. 12 cases were aparticulate. Biopsy was inadequate in 8 cases. Overall megaloblastic anaemia (26.6%) was most common followed by dual deficiency anemia. Multiple myeloma was the most common neoplastic pathology (13%) followed by followed by acute leukaemia’s (6%) and Chronic lymphoproliferative disorders (CLPDS) (5%). 1 case each of visceral leishmaniasis and malarial parasite were also noted. 4 cases (1.3%) of granulomatous pathology and 2 cases (0.6%) of Hodgkins lymphoma were diagnosed exclusively on bone marrow biopsy.Conclusions: Bone marrow aspiration and biopsy are complimentary to each other in diagnosing hematological disorders with biopsy being gold standard in the assessment of cellularity, pattern, extent of tumor infiltration and focal infiltration. It is more helpful in diagnosing granulomatous pathology and metastatic deposits of tumors eliciting fibrotic response.

Comparison Between 1-Needle Technique Versus 2-Needle Technique for Bone Marrow Aspiration and Biopsy Procedures

2013 ◽  
Vol 137 (7) ◽  
pp. 974-978 ◽  
Author(s):  
Alyaa Al-Ibraheemi ◽  
Tiffany Pham ◽  
Lei Chen ◽  
Erica Syklawer ◽  
Andres Quesada ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Painful Procedure ◽  
Multiple Parameters ◽  
Biopsy Specimens ◽  
Needle Technique ◽  
Procedural Time

Context.—Bone marrow examination is essential for diagnosis and staging of hematologic disorders. Traditionally, the bone marrow biopsy and aspirate are obtained with 2 needles at 2 separate sites. This approach is associated with significant discomfort, procedural time, and occasionally, morbidity. Although previous observations had suggested that a single-needle technique at one site is a simpler and less-painful procedure, there had been concern that the 1-needle technique may yield a suboptimal biopsy for diagnosis. Objective.—To conduct a systematic comparison of multiple parameters of bone marrow biopsy specimens obtained by the traditional 2-needle technique versus the 1-needle technique for bone marrow collection. Design.—We retrospectively evaluated 20 biopsy specimens obtained by each of the 2 mentioned techniques by comparing the morphologic quality of the biopsy, biopsy length, and biopsy cellularity. Results.—We found that the 1-needle technique yielded an adequate biopsy for diagnosis. The measured parameters of the samples obtained by the 1-needle versus 2-needle techniques were similar. Conclusion.—This study suggests that the 1-needle technique may be preferred for bone marrow aspirate and biopsy.

scholarly journals Bone marrow aspiration versus trephine biopsy: diagnostic value of both modalities when done simultaneously.

2021 ◽  
Vol 28 (12) ◽  
pp. 1844-1849
Author(s):  
Muhammad Ihtesham Khan ◽  
Asmara Rasheed ◽  
Sami Iqbal
Keyword(s):  
Bone Marrow ◽  
Qualitative Data ◽  
Bone Marrow Aspirate ◽  
Bone Marrow Aspiration ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Trephine Biopsy ◽  
Cross Sectional ◽  
The Mean ◽  
Study Setting

Objective: To compare diagnostic value of bone marrow aspiration and bone marrow trephine in reaching to final diagnosis. Study Design: Cross Sectional Descriptive study. Setting: Pathology Department of Khyber Teaching Hospital, Peshawar. Period: December 2015 to September 2016. Material & Methods: About 199 bone marrow procedure were done during study period. Nine cases were excluded because their trephine biopsy specimen was not available. So, the remaining 190 cases, of both the sexes and age above 2 years were included. Bone marrow aspiration and trephine biopsy were obtained from all the patients, and examined. Qualitative data was determined by frequency and percentages. Quantitative data was shown by mean and standard deviation. Results: 190 cases were included in the study. The mean age of the sample was 40 ±11.5 SD years (range: 2 to 81 years). Bone marrow aspirate alone could diagnose 139 (72.8%) cases while trephine biopsy alone was sufficient to diagnose 12 (6.3%) cases. Both the modalities showed similar diagnosis in 39 (20.9%) cases. Conclusion: Leukemias, anemias, and idiopathic thrombocytopenic purpura can be diagnosed by marrow aspiration alone. Aplastic anemia and myelofibrosis need marrow trephine for diagnosis. Both these modalities are important lest any diagnoses should be missed.

scholarly journals Bone Marrow Aspiration: A Randomized Controlled Trial Assessing the Quality of Bone Marrow Specimens Using Slow and Rapid Aspiration Techniques and Evaluating Pain Intensity

2015 ◽  
Vol 135 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Mette Grønkjær ◽  
Connie F. Hasselgren ◽  
Anne Sofie L. Østergaard ◽  
Preben Johansen ◽  
June Korup ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Bone Marrow Aspiration ◽  
Poor Quality ◽  
Hematological Disorders ◽  
Significant Difference ◽  
Blinded Study ◽  
Specimen Quality

Background/Aims: Bone marrow aspiration (BMA) is an essential procedure in the examination of hematological disorders, but there is limited evidence as to whether the aspiration rate affects specimen quality. We aimed to assess the specimen quality and pain intensity using slow (S-technique) or rapid (R-technique) aspiration. Methods: This was a single-center, prospective, randomized patient- and assessor-blinded study of 482 patients scheduled for BMA. Specimen quality was evaluated by grading bone marrow (BM) cellularity and counting the number of marrow particles. Pain was assessed using a visual analog scale (VAS). Results: We found a significant difference between the 2 groups with regard to the quality of specimens. For cellularity, the odds ratio (OR) for having a poor quality aspirate using the S-technique versus the R-technique was 3.05 [confidence interval (CI) 1.79-5.31]. For BM particles, the quality of specimens with the S-technique proved to be poor compared with the R-technique (OR 2.52; CI 1.51-4.28). We found a statistically significant difference of 1 VAS point (p < 0.001) of the median pain intensity in favor of the S-technique. Conclusion: Even though the pain intensity is significantly higher with the R-technique, the median difference is relatively small. We propose that the R-technique is preferable to the S-technique due to better specimen quality.

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