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 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 Plasma cell myeloma lytic lesions mimicking vanishing bone syndrome in a young patient

2019 ◽  
Vol 5 (4) ◽  
pp. 20190025
Author(s):  
Margaret Mwania ◽  
Naushad Karim ◽  
Sarah Wambui ◽  
Shamshudin Mohammedali ◽  
Allan Njau
Keyword(s):  
Bone Marrow ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Appendicular Skeleton ◽  
Plasma Cell Myeloma ◽  
Osteolytic Lesions ◽  
The Past ◽  
Lytic Lesions ◽  
Hiv Seropositive ◽  
Bone Marrow Disorder

Plasma cell myeloma is a bone marrow disorder characterized by neoplastic proliferation of plasma cells within the bone marrow replacing normal cells. We present a case report of a 25-year-old female with bilateral lower and upper limb pains. She had been seen in various health facilities for the past 2 years with progressively worsening disability. Skeletal survey revealed multiple osteolytic lesions in the appendicular skeleton resembling vanishing bone syndrome. Ultrasound-guided biopsy was done with histological diagnosis of plasma cell myeloma. This case is unique because of the young age at presentation, HIV seropositive status and atypical appearance of the lesions.

Bone marrow morphologic features, MyPRS, and gene mutation correlations in plasma cell myeloma

2019 ◽  
Vol 33 (2) ◽  
pp. 188-195
Author(s):  
Yansheng Hao ◽  
Daniel Khaykin ◽  
Levi Machado ◽  
Tayler van den Akker ◽  
Jane Houldsworth ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Gene Mutation ◽  
Plasma Cell ◽  
Plasma Cell Myeloma

Polycythaemia following treatment of lymphoplasmacytic lymphoma

2020 ◽  
Vol 13 (10) ◽  
pp. e235687
Author(s):  
Shailendra Prasad Verma ◽  
Bhupendra Singh ◽  
Rashmi Kushwaha ◽  
Punita Pavecha
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Examination ◽  
Severe Anaemia ◽  
Polycythaemia Vera ◽  
Lymphoplasmacytic Lymphoma ◽  
Transfusion Therapy ◽  
Remission Maintenance ◽  
Symptomatic Anaemia ◽  
Complete Haematological Response

A 61-year-old man presented to the department of clinical haematology in February 2016 with symptomatic anaemia, generalised lymphadenopathy and hepatomegaly. Routine investigations showed severe anaemia with the presence of lymphoplasmacytoid cells in the peripheral smear, and bone marrow examination with IHC and serum protein electrophoresis confirmed diagnosis of lymphoplasmacytic lymphoma. The patient received supportive transfusion therapy and combination chemotherapy. After VI cycles, the patient had a complete haematological response with marrow in remission. Maintenance rituximab was planned every 3 months for 2 years. At the time of first dose of maintenance rituximab, his haemoglobin (Hb) was 189 g/L with low normal erythropoietin level. During the last 3 years follow-up, his Hb ranged between 16.5 and 20.1 g/dL. All causes of secondary polycythaemia were ruled out. Workup for polycythAemia vera (PV), including JAK-2 and bone marrow, was not suggestive of PV. We labelled it as a case of polycythaemia due to undetermined aetiology.

scholarly journals Biclonal IgD and IgM Plasma Cell Myeloma: A Report of Two Cases and a Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Zhongchuan W. Chen ◽  
Ioanna Kotsikogianni ◽  
Jay S. Raval ◽  
Christine G. Roth ◽  
Marian A. Rollins-Raval
Keyword(s):  
Bone Marrow ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Protein Electrophoresis ◽  
Plasma Cell Myeloma ◽  
Clinical Behavior ◽  
Therapeutic Implications ◽  
Immunohistochemical Studies

Biclonal plasma cell myelomas producing two different isotypes of immunoglobulins are extremely rare entities; to date, the combination of IgD and IgM secretion by a biclonal plasma cell myeloma has not been reported. Bone marrow biopsy immunohistochemical studies in two cases revealed neoplastic plasma cells coexpressing IgD and IgM, but serum protein electrophoresis identified only the IgM monoclonal paraprotein in both cases. Biclonal plasma cell myelomas, while currently not well characterized in terms of their clinical behavior, should be distinguished from B-cell lymphoma with plasmacytic differentiation, given the different therapeutic implications. Both cases reported herein demonstrated chemotherapy-resistant clinical courses.

Morphologic and cytogenetic variables affect the flow cytometric recovery of plasma cell myeloma cells in bone marrow aspirates

2015 ◽  
Vol 37 (6) ◽  
pp. 797-808 ◽  
Author(s):  
C. H. Cogbill ◽  
M. D. Spears ◽  
P. Vantuinen ◽  
A. M. Harrington ◽  
H. Olteanu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Plasma Cell ◽  
Plasma Cell Myeloma ◽  
Myeloma Cells ◽  
Flow Cytometric

scholarly journals Liver involvement by plasma cell myeloma mimicking clear cell carcinoma, a potential pitfall.

2020 ◽  
Author(s):  
Fotini-Rosi Vagena ◽  
Heinz Sill ◽  
Christine Beham-Schmid
Keyword(s):  
Bone Marrow ◽  
Cell Carcinoma ◽  
Plasma Cell ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Correct Diagnosis ◽  
Low Back ◽  
Plasma Cell Myeloma ◽  
Morphological Variants ◽  
Histological Specimen

Abstract Background: Unusual morphological variants of plasma cell myeloma are a diagnostic challenge.Case presentation: A 60 year old woman with low-back pain was diagnosed with a plasma cell myeloma in the bone marrow. Concurrently a tumour was found in the liver. The histological specimen of the liver resembled a clear cell carcinoma, but the immunophenotype revealed plasma cell myeloma.Conclusion: In tumours with an extraordinary morphology and not conclusive immunohistochemical results the use of plasma cell antibodies may lead to the correct diagnosis.

scholarly journals Autoimmune myelofibrosis associated with autoimmune hemolytic anemia successfully treated with ruxolitinib

2021 ◽  
Author(s):  
Shuku Sato ◽  
Wataru Kamata ◽  
Yotaro Tamai
Keyword(s):  
Bone Marrow ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Transforming Growth Factor ◽  
Myeloproliferative Neoplasms ◽  
Bone Marrow Examination ◽  
Coombs Test ◽  
Bone Marrow Fibrosis ◽  
Cytokine Levels ◽  
Antiglobulin Test

Abstract A 55-year-old man suffered from dyspnea, general malaise, and jaundice. His laboratory date showed pancytopenia and hemolytic anemia, and computed tomography showed splenomegaly. Bone marrow examination revealed myelofibrosis (MF)-1. The hemolytic anemia was diagnosed as IgM autoimmune hemolytic anemia (AIHA) with negative direct and indirect Coombs test but positive IgM-direct antiglobulin test. We started ruxolitinib 20 mg, which improved not only bone marrow fibrosis, symptoms related to myeloproliferative neoplasms and splenomegaly, but also AIHA. AIHA may be associated with Autoimmune MF (AIMF), and cytokines such as transforming growth factor (TGF)-β are thought to be involved in such cases. This case suggests that ruxolitinib may improve the cytokine levels and may lead to the treatment of AIHA as well as AIMF.

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