scholarly journals Bone marrow touch imprint smears as an adjunct to bone marrow aspiration smears in hematological disorders

2015 ◽  
Vol 5 (9) ◽  
pp. 739-746
Author(s):  
S Upadhyaya Baskota ◽  
AR Joshi ◽  
SK Singh
Keyword(s):  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Plasma Cell ◽  
Residual Disease ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
P Value ◽  
Plasma Cell Myeloma ◽  
Morphological Examination ◽  
Myeloid Neoplasms

Background: Morphological examination of the marrow requires a combination of a properly prepared bone marrow aspirate smear, a trephine biopsy section and an imprint of core biopsy. Some conditions often result in a dry tap and are best studied by marrow biopsy.The major drawbacks of biopsy sections are their thickness, precludingfine morphologic detail.The objective of this study was to compare the diagnostic accuracy, cellularity and cytomorphology from bone marrow biopsy core imprint smears with bone marrow aspiration smears.Materials and Methods: Imprint smears were prepared from 138 cases subjected to bone marrow examination. The bone marrow aspiration, imprint smears andbone marrow biopsy sections were examined and were categorized into five different groups on cytomorphological basis: Non-malignant alterations and normal marrow, Myeloid neoplasms, Plasma cell myeloma, myelo-infiltrative disease and absence of residual disease and further delineated into specific entities wherever necessary.Results: Out of 138 cases, non-malignant alterations and normal marrow was the largest subgroup (N=87, 63%), followed by myeloid neoplasms (N=26, 18.5%), Plasma cell myeloma (N=13, 9.4%), myelo-infiltrative disease (N=9, 6.5%) and absence of residual disease (N=3, 2.2%). The diagnostic accuracy of imprint smears was highest (92%) followed by biopsy sections (89.9%) and aspiration smears (87%). Kappa analysis showed strong agreement (>0.8) and p-value was statistically significant (<0.001) while correlating the final diagnosis.Conclusion: Imprint smear technique is a simple, rapid, inexpensive and reliable procedure. The routine use of imprint smear in the bone marrow examination will serve as an invaluable adjunct to bone marrow aspiration and biopsy.Journal of Pathology of Nepal (2015) Vol. 5, 739-746

scholarly journals The Usefulness of Morphology in Diagnosing various Malignancies on Bone Marrow Examination in Adults- A Single Centre Study

2020 ◽  
Vol 24 (2) ◽  
pp. 123-127
Author(s):  
Nazia Khalid ◽  
Attika Khalid ◽  
Lubna Zafar ◽  
Nadia Arif ◽  
Mehmood Ul Hasan
Keyword(s):  
Bone Marrow ◽  
Myeloid Leukaemia ◽  
Plasma Cell ◽  
Myeloproliferative Neoplasms ◽  
Bone Marrow Examination ◽  
Cell Leukaemia ◽  
Polycythaemia Vera ◽  
Plasma Cell Myeloma ◽  
Single Centre ◽  
Morphological Examination

Introduction: Bone marrow is the site of involvement of various neoplasms. The objective of this study was to determine the incidence of various malignancies (Haematological and non-Haematological) in adults diagnosed on morphological examination of bone marrow. Materials and Methods: It was a single-centre, retrospective study conducted at the Department of Pathology, Fauji Foundation Hospital, Rawalpindi from January 2012 to December 2018. All patients above 15 years of age diagnosed as having Haematological or Non-Haematological malignancy involving bone marrow were included in the study. Data was analyzed using SPSS version 17. Results: A total of 275 adult patients had malignancies involving bone marrow; 233 (84.7%) were females and 42 (15.3%) were males.  Out of 275 patients, 50 (18.1%) patients had Acute Myeloid Leukaemia, 45 (16.3 %) had Chronic Myeloid Leukaemia (CML), 41 (14.9 %) having Non-Hodgkin lymphoma (NHL), 32 (11.6 %) having Acute Lymphoblastic Leukaemia (ALL), 31 (11.2 %) having Chronic Lymphocytic Leukaemia (CLL) and 27 (9.8 %) having Plasma cell Myeloma. Metastatic infiltrates were seen in 16 (5.8 %) patients. Myeloproliferative neoplasms (MPN) in 6 (2.1%), Essential Thrombocythaemia in 5 (1.8 %), Polycythaemia vera in 4 (1.4%), Primary myelofibrosis in 2 (0.7 %), Hodgkins Lymphoma in 2 (0.7 %), and Plasma Cell Leukaemia in 1 (0.3 %) patient were seen. Thirteen (4.7%) patients of Acute leukaemia and 6 (2.1%) patients of MPN required further testing by Immunophenotyping/Cytogenetics for a conclusive diagnosis. Conclusion: Leukaemias were the most common malignancies involving bone marrow, followed by Non-Hodgkin Lymphomas, Plasma cell myeloma and Metastatic infiltrates. Morphology by light microscopy remains the single most useful tool for the diagnosis of malignancies, especially in under-resourced centres.

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.

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

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

Evaluation of a 5-Color Flow Cytometric Technique for Immunophenotyping and Quantitation of Plasma Cell Myeloma in Post-Therapy Bone Marrows.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5036-5036
Author(s):  
Tove Isaacson ◽  
Andrzej Jakubowiak ◽  
Lloyd Stoolman ◽  
Usha Kota ◽  
William Finn ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
Minimal Residual Disease ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Residual Disease ◽  
Plasma Cell Myeloma ◽  
Color Flow ◽  
Flow Cytometric ◽  
Minimal Residual

Abstract Multiparameter flow cytometry is a useful tool for comprehensive immunophenotyping of plasma cell myeloma, and has been proposed as a sensitive method for the evaluation of minimal residual disease in patients following treatment. This study aimed to assess the value of flow cytometry in quantitation of residual disease, in comparison to routine morphologic examination of first-pull bone marrow aspirate smears, in myeloma patients post-therapy. Heparinized bone marrow aspirates were obtained from 27 treated patients with plasma cell myeloma. Cells were prepared for 5-color flow cytometric analysis within 24-hours of specimen draw. Surface membrane staining with anti-CD19, CD20, CD38, CD45, CD56, and CD138 was followed by ammonium chloride lysis of red cells. Fixed and permeabilized cells were analyzed for cytoplasmic light chains to confirm clonality. Data were acquired using an FC500 flow cytometer (Beckman-Coulter), analyzed with CXP software with plasma cells isolated based on bright CD38+ or CD138+ expression. A median of 97,639 cellular events (range 14,279 to 262,508) were collected per analysis. Flow cytometric enumeration of plasma cells was compared to 500-cell differential counts of Wright-Giemsa-stained first-pull aspirate smears from the same cases. The median plasma cell count as determined by flow cytometry was 0.5% (range 0–7.9%). The median plasma cell count estimated by morphologic review was 8.0% (range 0–84.4%). Flow cytometry underestimated the plasma cell content in all but one case. Clonal plasma cells expressed CD38 and CD138 in all cases; 87.5% (21/24) coexpressed CD56, 25% (6/24) coexpressed CD45, and 4.2% (1/24) coexpressed CD19. None was positive for CD20. Although detection of minimal residual disease after therapy for acute leukemia is routinely achieved by flow cytometric analysis, successful quantitation of minimal residual disease in treated myeloma patients using flow cytometry remains limited as it usually underestimates the plasma cell content of bone marrow samples compared to routine morphology of first-pull aspirates. We have observed that this holds true for both pre-treatment and post-treatment specimens. Causes for the discrepancy may include hemodilution of second-pull aspirates used for flow cytometry, fragility and loss of plasma cells during preparation for flow cytometry, and incomplete disaggregation of plasma cells from bone marrow spicules. With improved outcome of treatments, better and more reliable methods of detection of minimal residual disease are needed for optimal prognostic stratification. We are currently validating alternative methods, which may offer more sensitivity while at the same time allow more objectivity, for assessing the amount of minimal residual disease in myeloma patients.

scholarly journals The importance of flowcytometry study with the first aspirate taken during bone marrow aspiration in the diagnosis of multiple myeloma and follow-up of minimal residual disease

2021 ◽  
Vol 8 (4) ◽  
pp. 219-224
Author(s):  
Ali Eser
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Flow Cytometry ◽  
Plasma Cells ◽  
Residual Disease ◽  
Bone Marrow Aspiration ◽  
Morphological Examination ◽  
Flow Cytometric ◽  
Flow Cytometric Study

Objective: Flow cytometry (FC) is a diagnostic method supporting traditional morphological examination in disease follow-up and the diagnosis of Multiple myeloma (MM). Normal and atypical plasma cells (PCs) can be told apart from each other by means of FC method. The plasma cell rate is the highest in the blood obtained in the first aspirate during bone marrow aspiration in MM. Material and methods: A total of 60 patients that have been diagnosed with MM between 2018 and 2020, including 30 patients whom flow cytometry was studied with the first aspirate during bone marrow aspiration, and 30 patients whom FC was studied with the second aspirate were included in our study. The characteristics of the patients were analyzed retrospectively from their files. Results: The median ratio of plasma cells (PCs) detected by FC and bone marrow biopsy  was 17,5% and 44%, respectively. While this rate was median 37,5% in patients that flow cytometric study was performed with the first aspirate, the rate was found to be median 7% in patients that FC was performed with the second sample. The PCs rates were statistically significantly higher with the flow cytometric study with the first aspirate than the second one (p=0.000). Conclusion: Flow cytometric study with the first aspirate during bone marrow aspiration in patients with MM is diagnostically important.  

scholarly journals Correlation of bone marrow aspiration and biopsy findings in diagnosing hematological disorders - a study of 89 cases

2014 ◽  
Vol 4 (7) ◽  
pp. 534-538 ◽  
Author(s):  
S Parajuli ◽  
A Tuladhar
Keyword(s):  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Wide Spectrum ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Histopathological Study ◽  
Trephine Biopsy ◽  
Aspiration Cytology ◽  
Serological Tests ◽  
Hematological Diseases

Background: Bone marrow examination is an important diagnostic tool to evaluate various disorders which includes both neoplastic and non- neoplastic hematological diseases. Few studies have compared the relative value of aspirate with trephine biopsy. The present study was conducted to compare the role of bone marrow aspirate and trephine biopsy to formulate an effective and rapid method for diagnosing wide spectrum of hematological diseases. Materials and Methods: This is a three year retrospective study done from July 2010 to June 2013. A total of 95 cases presented with clinical haematological disorders; of which only 89 were biopsied and the correlation done. All the smears and sections were reviewed for morphological details and findings on aspirate and biopsy and compared to each other. Results: Out of the 89 cases selected for study; bone marrow aspiration revealed diagnostic materials in 75 cases and 14 cases were inconclusive for a definite diagnosis. The diagnostic accuracy of the bone marrow aspiration cytology was 84.26%. Eighty eight cases were diagnosed on trephine biopsy of bone marrow with diagnostic accuracy of 98.87%. Conclusion: Both the aspiration cytology and trephine biopsy complement each other for evaluating any haematological disorder. Though cellular morphology is better understood in marrow aspirates and is equally effective to biopsy in diagnosing various anemias and leukemias; however it is the histopathological study of trephine biopsy that gives well preserved marrow architecture with its all cellular and stromal components. modalities including radiological, microbiological and serological tests. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10294 Journal of Pathology of Nepal (2014) Vol. 4, 534-538

scholarly journals Importance of bone marrow biopsy in assessment of treatment response in a case of acute myeloid leukemia

2020 ◽  
Vol 8 (4) ◽  
pp. 180-182
Author(s):  
Kasula S ◽  
Poduval SK ◽  
Mounika B
Keyword(s):  
Bone Marrow ◽  
Treatment Response ◽  
Bone Marrow Biopsy ◽  
Residual Disease ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Chemotherapy Response ◽  
Acute Leukemias ◽  
Remission Status ◽  
Ancillary Studies

Chemotherapy response in acute leukemias is usually assessed by bone marrow examination along with ancillary studies like flowcytometry/ polymerase chain reaction for minimal residual disease (MRD). Decisions regarding post induction chemotherapy are based on bone marrow remission status. Bone marrow aspiration alone is asked by many oncologists/ hematologists for assessing the remission status. Rarely pockets/ clusters of blasts may not be picked up in the aspiration and the same for MRD also. Hence, bone marrow biopsy is necessary for those clusters/ pockets of blasts. In this case report we are highlighting the importance of both aspiration and biopsy for assessing the treatment response.

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