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

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

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.02.3928 ◽

2021 ◽

Vol 28 (02) ◽

pp. 214-217

Author(s):

Asmara Sami ◽

Muhammad Ihtesham Khan ◽

Sami Iqbal

Keyword(s):

Bone Marrow ◽

Bone Marrow Aspiration ◽

Definitive Diagnosis ◽

Diagnostic Utility ◽

Cross Sectional ◽

Specific Diagnosis ◽

Pathology Department ◽

Qualitative Variables ◽

Study Setting ◽

Made In

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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A Comparative Study of Bone Marrow Aspiration and Bone Marrow Biopsy in Hematological Diseases

Journal of Nobel Medical College ◽

10.3126/jonmc.v4i1.12942 ◽

2015 ◽

Vol 4 (1) ◽

pp. 12-14

Author(s):

Nirajan Mainali ◽

Neha Homagai ◽

Pratap Sagar Tiwari ◽

Arun Giri

Keyword(s):

Bone Marrow ◽

Diagnostic Accuracy ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Diagnostic Value ◽

Trephine Biopsy ◽

Biopsy Material ◽

Hematological Diseases ◽

Bone Marrow Trephine Biopsy ◽

Common Diagnosis

Introduction: Bone marrow examination is an important diagnostic tool to evaluate various disorder including both neoplastic and non-neoplastic hematological diseases. The two most important techniques used for the diagnosis are bone marrow aspiration and bone marrow trephine biopsy which are complementary to each other.Aim and Objectives: To compare the diagnostic value of bone marrow aspiration and biopsy. Material and methods: A total of 88cases with both bone marrow aspiration and biopsy were included in the study. All the aspirate smears were routinely stained by Jenner Giemsa while the trephine biopsy sections were stained by routine Hematoxylin and Eosin stain.. All the smears and sections were reviewed and the findings on BMA and BMB were compared and the final correlation done.Result: Hypolastic marrow was the most common diagnosis followed by immune thrombocytopenic purpura (ITP). But the diagnostic accuracy of ITP on aspiration was 100 % in compare to hypoplastic marrow (81.25%). The diagnosis accuracy of BMA in our study was 84.09%.Conclusion: Bone marrow aspiration and biopsy complement each other. Bone marrow aspiration provides better study of the cell, whereas biopsy provides detail about the pattern of cellular distribution, hence when performed together it gives better diagnostic accuracy. Journal of Nobel College of Medicine Vol.4(1) 2015: 12-14

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

Hematology & Transfusion International Journal ◽

10.15406/htij.2018.06.00189 ◽

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.

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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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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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HIV Myelopathy- A cross-sectional study of constellation of bone marrow findings in HIV/AIDS

Biomedicine ◽

10.51248/.v41i4.904 ◽

2021 ◽

Vol 41 (4) ◽

pp. 815-820

Author(s):

Hemalatha Kuppan ◽

Vanishri Ashok ◽

Sridevi Hanaganahalli Basavaiah ◽

Urmila Niranjan Khadilkar ◽

Nirupama Murali

Keyword(s):

Bone Marrow ◽

Bone Marrow Aspirate ◽

Bone Marrow Aspiration ◽

Unknown Origin ◽

Absolute Lymphocyte Count ◽

Cd4 Count ◽

Clinical Indication ◽

High Morbidity ◽

Cross Sectional ◽

Hiv Aids

Introduction and Aim: Haematological manifestations in HIV disease is common and can happen at any phase during the disease course. Anemia and thrombocytopenia are the most frequent hematologic abnormalities and are associated with high morbidity and mortality. The objective of current study was to observe and analyse various spectrum of bone marrow changes and haematological abnormalities in HIV/AIDS and to correlate findings with CD4 count. Material and Methods: A total of 44 patients over a period of 5 years were included. Clinical findings, hematological profile, bone-marrow aspirate, biopsy findings and CD4 count of these patients were documented. The association between absolute lymphocyte count (ALC) and CD4 count were further established. Results: The most common clinical indication for bone-marrow aspiration and trephine biopsy was pancytopenia (47.3%), pyrexia of unknown origin (15.1%), and unresolving hepatosplenomegaly (13.6%). Anemia (72.7%) was commonest haematological abnormality. Bone marrow aspirate was normocellular in majority of patients. Marrow findings were correlated with CD4 count and were found to be statistically significant. Tri-lineage dysplasia was observed in 9.1% of patients, and megakaryocytic dysplasia being the commonest(61.4%). Histiocytic aggregates (27.3%) were noted among which 6.8% showed acid fast bacilli in Ziehl-Neelsen stain. Fungal stains revealed histoplasmosis in 4.5% patients. Conclusion: There was a strong negative association between presence of anemia and dysplasia and CD4 count. When CD4 was <200/µL and ALC<1000/mm3, presence of anemia and dysplasia affecting various cell lines were commonly observed; therefore, can be used as indicators to assess the severity of the disease.

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

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20182111 ◽

2018 ◽

Vol 5 (3) ◽

pp. 608 ◽

Cited By ~ 1

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.

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