Diagnostic utility of bone marrow aspiration biopsy in definitive diagnosis in cases of hepatosplenomegaly.

Objective: To determine the diagnostic utility of bone marrow aspirate in finding cause of hepatosplenomegaly. Study Design: Cross Sectional Descriptive study. Setting: Pathology Department of Khyber Teaching Hospital. Period: August 2017 to December 2017. Material & Methods: A total of 116 cases were referred to Pathology department for workup of hepatosplenomegaly during study period. Patients were subjected to bone marrow aspiration and biopsy. The cases were diagnosis was made and those where no specific diagnosis could be made were noted. Mean and standard deviation were used for quantitative variables. Frequency and percentages were used for qualitative variables. Results: Mean age of the study sample was 45±9 years (range 2 -64 years). There were 66 (56.89%) males and 50 (43.10%) females. No specific diagnosis could be made in 36 (31.03%) cases of hepatosplenomegaly. In remaining 80 (68.96%) cases a definitive diagnosis could be made on examining bone marrow aspiration. So the diagnostic utility of bone marrow aspiration examination was 68.96%. Conclusion: Bone marrow aspiration is valuable and diagnostically important tool for workup of cases of hepatosplenomegaly.

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

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.12.6114 ◽

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.

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TO DETERMINE THE FREQUENCY OF VISCERAL LEISHMANIASIS IN PERIPHERAL CYTOPENIC PATIENT IN PATHOLOGY DEPARTMENT HAYATABAD MEDICAL COMPLEX.

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2014.4.2.560-566 ◽

1969 ◽

Vol 4 (2) ◽

pp. 560-566

Author(s):

ZARD ALI KHAN ◽

MOHAMMAD SAJJAD ◽

IMRAN UD DIN ◽

MUKAMIL SHAH ◽

SHAH JEHAN

Keyword(s):

Bone Marrow ◽

Visceral Leishmaniasis ◽

Case Series ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Total Leukocyte Count ◽

Full Blood Count ◽

Female Ratio ◽

Pathology Department ◽

Case Series Study

BACKGROUND: Visceral Leishmaniasis is a chronic disease and was first described in 1903, byLIESHMAN and DONOVAN. The disease is common in tropical and sub tropical areas of the worldwith various hematological manifestations. It is characterized by fever, visceromegaly, weight loss,pancytopenia and hypergammaglobulenemia. The disease is silent killer, invariably killing almost alluntreated patients, but curable with hematological improvement within 4-6 weeks of treatment.OBJECTIVE: To determine the frequency of Visceral Leishmaniasis in patints with cytopenias .MATERIAL AND METHODS: A descriptive study conducted in Pathology department, HayatabadMedical Complex, Hayatabad from September 1, 2012 to August 31, 2013. This study comprises of 126patients, subjected to complete blood counts. Diagnosis were confirmed by finding Amastigote( L/Dbody) from bonemarrow aspirate. All the patients who were referred to pathology Department of thehospital for bone marrow examination, with the results of peripheral blood using automatedHaematology analyzer, Sysmex KX 21 showing cytopenia were included in the study. Consent wastaken from the patient for bone-marrow aspiration procedure. After consent detailed history, physicalexamination was done.Laboratory investigations i.e. full blood count, which includes hemoglobin estimation, white blood cell,red blood, and platelet count.Bone marrow cytology (Giemsa stain) was recorded on the designed profroma.Posterior superior iliac spine (PSIS) was used as the site for aspiration in adults and children over 2years of ageRESULT: Descriptive case series study of 126 patients of peripheral cytopenia. In which 77 (61.1%)patients were males and 49 (38.9%) were female with male to female ratio of 1.57: 1 It was also foundin this study that visceral leishmaniasis was present in 29 (23%) of cases and the male: female were 1.6:1. Result of the automated hematology analyzer of peripheral cytopenic patients in visceralleishmaniasis show that all of the patients were having total leukocyte count less than 4000/cmm(100%). The hemoglobin level wass less than lOgm/dl in 26 cases (87.7%) and more than lOgm/dl inthree cases (10.3%). In case of platelets count, 27 cases (93.1%) were having platelets count less than150000/cmm.CONCLUSION: Incidence of visceral leishmaniasis is highier in children age group 1-10 years, alsomales are more prone than females. Leukopenia is recorded in all (100%) of the cases, followed bythrombocytopenia (93.1%) and anemia (Hb <10gm %) 87.7% cases.KEY WORD: Visceral Leishmaniasis, Kala Azar, Amastigote (L/D body)

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Comparison of KAtex, Bone Marrow Aspiration and DAT for the Diagnosis of Visceral Leishmaniasis

Bangladesh Journal of Infectious Diseases ◽

10.3329/bjid.v6i1.42660 ◽

2019 ◽

Vol 6 (1) ◽

pp. 12-15

Author(s):

Ishrat Sharmin ◽

AKM Quamruzzaman ◽

Rezina Parveen ◽

M Abdulah Yusuf ◽

Rashida Akter Khanam

Keyword(s):

Bone Marrow ◽

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Bone Marrow Aspiration ◽

Cross Sectional Study ◽

Cross Sectional ◽

Medical College ◽

Kala Azar ◽

History Of ◽

One Year

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar. Objectives: The aim of the present study was to compare KAtex, Bone marrow aspiration and DAT to diagnose VL. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the Department of Parasitology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala-azar (VL) cases of different age and sex attending IEDCR, Dhaka from different Kala-azar endemic areas of Bangladesh were selected for this study. Patients having fever for more than 2 weeks, with or without splenomegaly, having history of loss of body weight following onset of fever were clinically suspected as Kala-azar cases. Microscopy and culture was performed in bone marrow (BM). KAtex was performed with urine sample. Agglutination of sensitized latex indicated presence of Leishmania donovani antigen in urine and thereby visceral leishmaniasis. No agglutination indicates absence of antigen in urine. DAT was done with serums of all cases. Result: Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60(46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex and DAT. Among 60 BM negative cases, 15 were positive by KAtex and 23 were positive by DAT. The sensitivity of KAtex was 100.0% and specificity was 75.0%. The sensitivity of DAT was 100.0% and specificity is 61.6%. Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL in comparison with DAT. Bangladesh Journal of Infectious Diseases, June 2019;6(1):12-15

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Role of Bone Marrow Trephine Biopsies in the Diagnosis of Hematological and Non-Hematological Disorders

Nepalese Medical Journal ◽

10.3126/nmj.v3i2.31042 ◽

2020 ◽

Vol 3 (2) ◽

pp. 347-351

Author(s):

Kricha Pande ◽

Arvind Kumar Sinha ◽

Anju Pradhan ◽

Suman Rijal ◽

Nisha Keshari Bhatta

Keyword(s):

Bone Marrow ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Cross Sectional Study ◽

Trephine Biopsy ◽

Cross Sectional ◽

Hematological Disorders ◽

Bone Marrow Trephine ◽

Bone Marrow Trephine Biopsy ◽

Conclusive Diagnosis

Introduction: Bone marrow examination has become increasingly important for the diagnosis and treatment of hematologic and other illnesses. Bone marrow aspirates along with their peripheral smears and bone marrow trephine biopsies are considered to be complementary.Materials and Methods: This hospital-based, cross-sectional study was carried out in the Department of Pathology for one year (March 2011 to March 2012) at BPKIHS, Dharan. Fortyeight adequate bone marrow aspirates along with peripheral blood smears and trephine biopsies were selected and examined. Bone marrow trephine biopsies performed simultaneously with aspirate were correlated with the other two fi ndings to arrive at a conclusive diagnosis.Results: Bone marrow aspiration and trephine biopsy were found as complementary tests in 51.8% of cases. Bone marrow trephine biopsy provided a conclusive diagnosis in 25.9% of cases where bone marrow aspiration was inconclusive. Bone marrow aspiration alone was diagnostic in 22.2% of cases. In 43.7% of cases both aspiration and trephine biopsy were unable to provide a specificdiagnosis. Bone marrow biopsy was the diagnostic investigation in cases like aplastic anemia, myelofi brosis, and hypoplastic marrow.Conclusions: This study concludes that bone marrow aspiration smear along with peripheral smear findings and marrow trephine biopsy is required to arrive at a conclusive result.

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Bone Marrow Examination in Cases of Pancytopenia

Journal of Nepal Medical Association ◽

10.31729/jnma.209 ◽

2008 ◽

Vol 47 (169) ◽

Cited By ~ 14

Author(s):

Abhimanyu Jha ◽

G Sayami ◽

R C Adhikari ◽

A D Panta ◽

R Jha

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Pure Red Cell Aplasia ◽

Cross Sectional Study ◽

University Teaching ◽

Cross Sectional ◽

Erythroid Hyperplasia ◽

Niemann Pick

This study was carried to identify the causes of pancytopenia and to fi nd out the bone marrowmorphology in cases of pancytopenia.It was a cross sectional study conducted over a period of two years in the Department of Pathology,Tribhuvan University Teaching Hospital. Bone marrow aspiration smears of patients fulfi lling thecriteria of pancytopenia were examined. The data obtained were analyzed using measures of centraltendency.One hundred and forty eight cases underwent bone marrow aspiration and it constituted 15.74% oftotal cases. Mean age was 30 years (range, 1-79 years). 42 cases were children (28.37%). Male: femaleratio was 1.5:1. The commonest cause was hypoplastic bone marrow seen in 43 cases (29%) followedby megaloblastic anemia in 35 cases (23.64%), and hematological malignancy in 32 cases (21.62%).Erythroid hyperplasia was seen in 29 cases (19.6%) and normal bone marrow was seen in 5 cases(3.38%). There was one case each of Niemann-Pick disease and metastatic neuroblastoma in childrenand chronic pure red cell aplasia and leishmaniasis in adults. Acute leukemia was the commonesthematological malignancy. In children, commonest fi nding was hypoplastic bone marrow (38.1%)while in adults megaloblastic anemia (30.18%) was commonest fi nding followed by hypoplasticanemia (25.47%).In present study bone marrow examination was able to establish diagnosis in 77% of cases. Hypoplasticmarrow was the commonest diagnosis, followed by megaloblastic anemia, and hematologicalmalignancies.Key Words: Bone marrow aspiration, hypoplastic anemia, leukemia, megaloblastic anemia,pancytopenia

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Bone marrow aspiration cytology in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi State, Nigeria: Indications and diagnostic utility

Annals of African Medical Research ◽

10.4081/aamr.2019.72 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Rufai Abdu Dachi ◽

Falmata Grema Mustapha ◽

Saleh Yuguda ◽

Modu Baba Kagu ◽

Ali Adamu Gwaram ◽

...

Keyword(s):

Bone Marrow ◽

Teaching Hospital ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

University Teaching ◽

Anatomical Site ◽

Diagnostic Utility ◽

Monitoring Tool ◽

Aspiration Cytology ◽

Hematological Diseases

Bone Marrow Aspiration (BMA) cytology is an important diagnostic and monitoring tool where cytological details of the marrow elements are examined using light microscopy. Various hematological diseases are diagnosed and monitored by using BMA. This study aimed at reporting a 3-year BMA experience of Department of Hematology and Blood Transfusion of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi. This was a retrospective study that involved the use of records of the bone marrow aspirates done from January 1st, 2016 to December 31st, 2018. The age, sex, indications for BMA, anatomical site and final bone marrow diagnosis were collated. The data was analyzed using SPSS Version 23.0 software. One hundred and three (103) bone marrow aspirations were performed during the period under review. Two third of the participants were males, with the median age of 40.0 years and a range of 5 months to 92 years. The commonest indication for BMA was recurrent anemia 45.6%, followed by splenomegaly, fever and lymphadenopathy with 11.7% each. While, the commonest diagnosis by BMA was megaloblastic anemia (28.2%). Mixed nutritional deficiency and Bone Marrow (BM) metastasis are the commoner BMA diagnoses with 12.6% each. Recurrent anemia is the commonest indication for BMA and nutritional anemias (megaloblastic and combined nutrients deficiency) are the commonest BMA diagnoses in Bauchi. Proper evaluation of patients by the clinicians before referral is recommended to ensure that only those that really need the procedure are subjected to it.

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Evaluation of bone marrow in patients with pancytopenia

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i4.6875 ◽

2012 ◽

Vol 2 (4) ◽

pp. 265-271 ◽

Cited By ~ 3

Author(s):

R Pathak ◽

A Jha ◽

G Sayami

Keyword(s):

Bone Marrow ◽

Hematological Malignancies ◽

Diagnostic Yield ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Clinical Findings ◽

Trephine Biopsy ◽

Cross Sectional ◽

Hypoplastic Anemia

Background: Pancytopenia is a common hematological finding resulting from varieties of disease processes that require evaluation of bone marrow. This study was carried out to evaluate bone marrow findings in patients presenting with pancytopenia.Materials and Method: This was a prospective cross sectional study carried out to identify the causes of pancytopenia based on bone marrow examination. Bone marrow examinations were performed in 503 cases for different indications over a period of one year.Results: One hundred and two (20.27%) cases fulfilled the criteria of pancytopenia. Trephine biopsy was possible only in 48 cases. In 75% cases aspiration findings were similar to biopsy. Mean age of patients was 38.8 years. Maximum number of cases was seen in age group of 15-30 years. Hypoplastic anemia was the commonest cause followed by hematological malignancies, megaloblastic anemia, leishmaniasis and Gaucher disease. Bone marrow examination alone was able to establish the diagnosis in 76.5% cases. In rest marrow findings were nonspecific and in 4.9% cases findings were normal.Conclusion: Bone marrow aspiration coupled with trephine biopsy can diagnose majority but not all the cases of pancytopenia. Hypoplastic anemia, hematological malignancies and megaloblastic anemia are the commonest causes of pancytopenia. Maximum diagnostic yield can be achieved by correlation with clinical findings, peripheral blood findings and with other laboratory and radiological parameters.Journal of Pathology of Nepal (2012) Vol. 2, 265-271DOI: http://dx.doi.org/10.3126/jpn.v2i4.6875

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Megakaryocytic alterations in thrombocytopenia: A bone marrow aspiration study

Journal of Pathology of Nepal ◽

10.3126/jpn.v6i11.15673 ◽

2016 ◽

Vol 6 (11) ◽

pp. 914-921

Author(s):

S Pokharel ◽

P Upadhyaya ◽

S Karki ◽

P Paudyal ◽

B Pradhan ◽

...

Keyword(s):

Bone Marrow ◽

Morphological Changes ◽

Bone Marrow Aspiration ◽

Cross Sectional Study ◽

P Value ◽

Microsoft Excel ◽

Chi Square ◽

Cross Sectional ◽

The Common ◽

One Year

Background: Megakaryocyte morphology plays an important role in thrombopoiesis. A defect in any stage of megakaryocytopoiesis can lead to dysmegakaryocytopoiesis and thrombocytopenia. This study was conducted to understand megakaryocytic alterations and their contribution in the diagnosis of cases of thrombocytopenia.Materials and Methods: This was a cross-sectional study was conducted on all consecutive cases of bone marrow aspirates of thrombocytopenia over a duration of one year in BPKIHS. Megakaryocyte morphology was studied with a 100X objective. Data were entered into Microsoft excel 10 and analysed with SPSS version 11.5. Descriptive statistics charted and Chi-square tests were done for inferential statistics to find any association at 95% Confidence Interval.Results: Among the 38 subjects, megakaryocytic thrombocytopenia (44.7%) was the most common cause of thrombocytopenia. Hypolobated megakaryocytes (63.2%), bare megakaryocytic nuclei (57.9%) were the common morphological changes in megakaryocytes. Odds of increased megakaryocyte count in megakaryocytic thrombocytopenia was found to be 12.5 times than for other causes of thrombocytopenia and the presence of bare megakaryocytic nuclei in MTP was statistically significant. (p –value<0.05)Conclusion: Many similarities were observed in megakaryocytic morphology among different hematological diseases. However, increased megakaryocyte count and presence of bare megakaryocytic nuclei, hypolobated forms were significant in megakaryocytic thrombocytopenia.

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Sedative and Analgesic Effects of Intravenous Midazolam and Ketamine Combination in Bone Marrow Aspiration and Biopsy of Childhood Cancer

Zahedan Journal of Research in Medical Sciences ◽

10.5812/zjrms.118151 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Seyed Mohammad Nasiraldin Tabatabaei ◽

Ghasem Miri-Aliabad ◽

Shahram Borjian Boroojeny ◽

Ali Arab

Keyword(s):

Bone Marrow ◽

Side Effects ◽

Bone Marrow Aspiration ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Analgesic Effects ◽

Sedation And Analgesia ◽

The Mean ◽

Waking Up

Background: Various drugs, including ketamine and midazolam, are used for sedation in children. Objectives: This study aimed to evaluate the effectiveness of intravenous midazolam and ketamine combination in bone marrow aspiration and biopsy in children with cancer. Methods: This descriptive cross-sectional study was conducted on 100 children aged six months to 17 years candidates for bone marrow aspiration or biopsy. Sampling was easy, accessible, and sequential. Children were injected with 0.05 mg/kg midazolam and 1 mg/kg ketamine for sedation and analgesia. Then, sedation rate, restlessness, nausea, vomiting, laryngospasm, and decreased oxygen saturation were assessed. Data were analyzed using SPSS version 18 software. Results: The mean age of children was 6.8 ± 4.3 years. The mean degree of sedation based on the modified Ramsey score was 5.2 ± 0.74. Nausea and vomiting were observed in nine (9%) children. Six (6%) children had arterial saturation of less than 90%. Twelve (12%) children showed restlessness when waking up. There were no cases of laryngeal spasms. Conclusions: The present study showed that the intravenous midazolam and ketamine combination provides suitable sedation and analgesia to children, with low and negligible side effects.

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CORRELATION OF TRISOMY 12 WITH CLINICAL FEATURES AND OTHER LABORTARY PARAMETERS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKAEMIA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.2679 ◽

2021 ◽

Vol 71 (2) ◽

pp. 473-77

Author(s):

Ali Ahmed ◽

Ch Altaf Hussain ◽

Hamid Saeed Malik ◽

M Abdul Naeem ◽

Rafia Mehmood ◽

...

Keyword(s):

Bone Marrow ◽

Chronic Lymphocytic Leukaemia ◽

Lymphocytic Leukaemia ◽

Bone Marrow Aspiration ◽

Armed Forces ◽

Cross Sectional ◽

Course Of Illness ◽

Pathologic Features ◽

Trisomy 12 ◽

Binet Stage

Objective: To determine the frequency of trisomy 12 in B-Cell chronic lymphocytic leukaemia (CLL), to correlate its association with clinico-pathologic features and to determine the role of this cytogenetic defect to the prognosis. Study Design: Cross sectional study. Place and Duration of Study: Haematology department, Armed Forces Institute of Pathology, Rawalpindi, from May 2017 to Aug 2018. Methodology: A total of 56 newly diagnosed patients of Chronic Lymphocytic Leukaemia were included in the study. Patients were diagnosed on the basis of National Cancer Institute Working Group guidelines. A detailed history and thorough clinical examination were performed and complete blood counts, biochemical profile, bone marrow examination, immunophenotyping on bone marrow/peripheral blood samples were done for the diagnosis of Chronic lymphocytic leukaemia. Interphase FISH studies were performed on blood/bone marrow aspiration for detection of Trisomy 12 were performed. Results: Out of 56 patients, trisomy was detected in 12 (10.7%) patients. Out of 7 patients with trisomy 12, five patients presented in late stages (Binet stage B and C), however this association of Trisomy 12 with Binet stage was also statistically insignificant (p=0.474). About six with trisomy 12 were positive for CD 38, however this association was also not statistically significant (p=0.124). Results revealed that patients having trisomy 12 underwent chemotherapy at diagnosis and during follow ups as compared to patients having other cytogenic abnormalities. Moreover, patient with trisomy 12 develop progression in disease during course of illness, however association was statistically insignificant (p>0.05)............

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