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

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)

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 Rare splenic complications and specific serology: decisive diagnostic tools in two cases of visceral leishmaniasis

2012 ◽  
pp. 274-277
Author(s):  
Andrea Celestini ◽  
Federica Paglia ◽  
Orlando Dell’ Unto ◽  
Riccardo Guarisco ◽  
Claudio Puoti
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Presentation ◽  
Splenic Rupture ◽  
Splenic Infarction ◽  
Diagnostic Tools ◽  
Minor Trauma ◽  
Vector Borne ◽  
A Minor

Introduction: Visceral leishmaniasis (VL) is a major endemic vector-borne disease in Southern Europe. We present two cases of VL, both characterized by splenic complications. Methods and results: Case 1: A 47-year-old female presented with effort angina, hepatosplenomegaly and pancytopenia. The clinical course was complicated by splenic infarction. Although bone marrow biopsy failed to show amastigotes, diagnosis was performed by a fast agglutinating screening test (FAST) and confirmed by a direct agglutinating test (DAT). The patient was treated successfully with AmBisome. Case 2: A 22-year-old male who had undergone a splenectomy to treat splenic rupture related to a minor trauma four months earlier presented with fever, nocturnal sweats and weight loss. The lack of pancytopenia was due to the absence of the spleen. The first biopsy did not identify parasites, but because the FAST had been positive, another bone marrow biopsy was performed, which demonstrated leishmaniasis. This patient was treated with the same schedule of AmBisome infusion. Discussion: 1) The clinical presentation of VL can be atypical, 2) splenic complications can characterize this disease, and 3) specific serology may be an important tool to reach a diagnosis.

scholarly journals Hematological profile in visceral leishmaniasis

2013 ◽  
Vol 2 (2) ◽  
pp. 39-44 ◽  
Author(s):  
Y Agrawal ◽  
AK Sinha ◽  
P Upadhyaya ◽  
SU Kafle ◽  
S Rijal ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Plasma Cells ◽  
Parasite Load ◽  
Clinical History ◽  
Bone Marrow Examination ◽  
Severe Form ◽  
P Value ◽  
Cross Sectional ◽  
Haematological Profile

INTRODUCTION: Visceral Leishmaniasis is the most severe form of leishmaniasis and can be fatal in the absence of treatment. Nepal, India, Bangladesh, Brazil and Sudan constitute five countries of the world where more than 90% of visceral leishmaniasis occurs. The aim of this study is to evaluate haematological profile with available clinical data in visceral leishmaniasis patients and to detect LD bodies among them. MATERIALS AND METHODS: It is a hospital based cross sectional study conducted in the Department of Pathology, BPKIHS, Dharan, for the period of one year. LD bodies were calculated in bone marrow aspirate of forty clinically suspected cases by counting the number of parasites per 100 consecutive oil immersion fields. RESULTS: The age ranged from 2-60 years. Pyerxia was the most common sign (100%) followed by splenomegaly (82.5%), hepatomegaly (65%), and pallor (75%). Anemia was present in 90%, leucopenia in 67.5% and thrombocytopenia in 72.5% cases. Bicytopenia and pancytopenia were observed in 40% and 25% cases, respectively. On peripheral examination RBCs were predominantly normocytic normochromic. On bone marrow examination normocellular marrow and megaloblastic features were predominant findings followed by increased plasma cells. Low, moderate and high grade LD bodies were present in 7.5%, 37.5% and 55% of the cases respectively. Hepatomegaly, anemia, neutropenia and lymphocytosis were statistically significant to parasite load (p-value <0.05). CONCLUSIONS: Besides LD bodies in bone marrow aspirates, dyserythroblastic changes and increase plasma cells are common findings in leishmaniasis. Patient from endemic area with positive clinical history and findings should be examined for LD bodies in marrow if dyserythroblastic and increase plasma cell picture is found.  DOI: http://dx.doi.org/10.3126/ijim.v2i2.8320   Int J Infect Microbiol 2013;2(2):39-44

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.

scholarly journals Clinicohaematological & Aetiological Profile of Bicytopenic / Pancytopenic Children in Dehradun, India - A 5-Year Study

2021 ◽  
Vol 10 (18) ◽  
pp. 1347-1352
Author(s):  
Neelima Bahal ◽  
Avneesh Malviya ◽  
Sana Ahuja
Keyword(s):  
Bone Marrow ◽  
Clinical Features ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Megaloblastic Anaemia ◽  
Diagnostic Tools ◽  
Trephine Biopsy ◽  
Study Results ◽  
Haematological Profile ◽  
Paediatric Age

BACKGROUND Cytopenia (bicytopenia / pancytopenia) in paediatric age group patients presents with variable clinical features from pallor, fever to organomegaly. Causes vary from megaloblastic anaemia to fatal leukaemias. The purpose of the study was to evaluate the etiological and clinico-haematological profile in children with bicytopenia and pancytopenia. METHODS The present retrospective study was carried out in the section of haematology, Department of Pathology of Shri Guru Ram Rai Institute of Health and Medical Sciences, Dehradun. All paediatric cases (up to 18 yrs.) with bone marrow examination, that were presented as bicytopenia or pancytopenia by routine haematological investigations were included in the study. RESULTS A total of 126 cases were included in the study, out of which, bone marrow aspiration was done in all 126 cases and trephine biopsy was done in only 78 cases. In our study, bicytopenia and pancytopenia was seen in 57.9 % and 42.1 % cases respectively. Most cases were recorded in 2nd decade. Pallor and fever were frequently observed clinical features in both cytopenias. Splenomegaly, lymphadenopathy and hepatomegaly were observed more in bicytopenia (34.2 %, 28.8 % and 27.4 % respectively). Bleeding and petechial rash were more common in pancytopenia (30.2 % and 20.8 % respectively). Anaemia and thrombocytopenia (67.1 %) were commonest combinations of bicytopenia followed by anaemia and leucopenia (26.0 %) and thrombocytopenia and leucopenia (6.8 %). CONCLUSIONS Bone marrow aspiration and trephine biopsy are important diagnostic tools in evaluating the cases of cytopenia. Both procedures are complementary to each other. KEY WORDS Bicytopenia, Pancytopenia, Megaloblastic Anaemia, Leukemia, Children

scholarly journals HEMATOLOGICAL CHARACTERISTICS OF YEMENI ADULTS AND CHILDREN WITH VISCERAL LEISHMANIASIS. COULD EOSINOPENIA BE A SUSPICION INDEX?

2017 ◽  
Vol 9 (1) ◽  
pp. 2017056 ◽  
Author(s):  
Jameel Al-Ghazaly ◽  
Waled Al-Dubai ◽  
Munasser Abdullah ◽  
Leila Al-Gharasi
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Peripheral Blood ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Control Group ◽  
Significant Difference ◽  
Adults And Children ◽  
Frequent Accompaniment ◽  
Suspicion Index

Background and objectives: Delay in the diagnosis of visceral leishmaniasis (VL) particularly in non-endemic areas is associated with higher mortality. In our experience, we found that marked bone marrow eosinopenia was a very frequent accompaniment of VL and might be a useful clue for the diagnosis, which indicates the opportunity for further morphological assessment. The aim of this study was to describe the hematological characteristics including peripheral blood and bone marrow findings of Yemeni adults and children with VL.Methods: We conducted a descriptive analytic study to evaluate systematically peripheral blood and bone marrow findings of Yemeni adults and children with VL. Peripheral blood and bone marrow aspiration of patients with bone marrow aspirate confirmed VL were examined. Forty-seven patients with the main age (±SD) of 17.34±11.37 years (Range: 1-60) were included in the study. Fifty-one non-VL subjects with splenomegaly and pancytopenia or bicytopenia served as control group.Results: All patients with VL had anemia, 41 (87%) leukopenia, 42 (89%) neutropenia, 44 (94%) thrombocytopenia, 42 (89%) eosinopenia, 34 (72%) pancytopenia and 13 (28%) had bicytopenia. In bone marrow examination 40 (85%) showed hypercellularity, 44 (94%) eosinopenia, 24 (51%) dyserythropoiesis, 22 (47%) lymphocytosis, 8 (17%) plasmacytosis, 27 (57%) decreased iron stores and 20 (43%) showed decreased sideroblasts. Comparison of VL patients with the control group showed significantly more frequent peripheral blood eosinopenia and lymphopenia and marrow eosinopenia. There was no significant difference between adults and children in any of the hematological features.Conclusion: Anemia, leukopenia, neutropenia, thrombocytopenia, eosinopenia, pancytopenia and marked bone marrow eosinopenia were the most common findings. The finding of marked bone marrow eosinopenia is a significant clue for the diagnosis of visceral leishmaniasis in patients who present with splenomegaly associated with cytopenias. This finding is particularly valuable in non-endemic areas.Keywords: Visceral Leishmaniasis, Yemen, Early Diagnosis, Hematological Features, Bone Marrow Eosinopenia.

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.

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.

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.

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