scholarly journals Bone Marrow Clot Section a Useful Tool for Diagnosis of Haematological Diseases- A Case Series

Author(s):  
Parul Garg ◽  
Harjot Kaur ◽  
Ishwer Tayal ◽  
Aradhana Singh Hada

Bone marrow examination is required for diagnosis of various haematological disorders. It includes both neoplastic and non-neoplastic disorders. Usually, bone marrow examination includes Bone Marrow Aspiration (BMA), bone marrow biopsy and bone marrow imprints. Bone marrow clot sections can also be an adjuvant of bone marrow examination. The bone marrow clot sections are prepared from the left-over blood after aspirate smears have been prepared. An adequate bone marrow clot section can be valuable for diagnosis of various diseases, especially in cases in which the aspirate and core biopsy material are inadequate or non contributory or it can be an adjuvant procedure. Little has been published about usefulness of bone marrow clot section. Studies are going on to evaluate the role of bone marrow clot section as an adjuvant or a diagnostic tool. This study includes a series of three cases in which bone marrow clot section was diagnostic.

1969 ◽  
Vol 4 (2) ◽  
pp. 560-566
Author(s):  
ZARD ALI KHAN ◽  
MOHAMMAD SAJJAD ◽  
IMRAN UD DIN ◽  
MUKAMIL SHAH ◽  
SHAH JEHAN

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)


Author(s):  
Dr. Atul C. Mujumdar ◽  
Dr. Akash C Chhabra

Introduction: There are various disorders in formation of blood in body. Bone marrow is one of them which involved variety of hematological and nonhematological disorders. Hematological disorders include myeloproliferative neoplasm (MPN), acute leukemia, hemato-lymphoid neoplasm and nutritional deficiency diseases whereas nonhematological disorders include infectious diseases infiltrating the bone marrow such as parasitic infections, tuberculosis and metastatic deposits. Bone marrows present various diseases with various clinical symptoms with the involvement of blood but peripheral blood picture alone does not reflect the nature of disease process. Depending upon the suspected diagnosis from clinical features and peripheral blood examination, that indication for bone marrow examination can be done. Examination of Bone marrow is useful in the diagnosis of both hematological and non-hematological disorders. The most important techniques used for the diagnosis of hematological disorders are trephine biopsy and bone marrow aspiration. For the interpretation of the disorder of bone marrow history, clinical finding, peripheral blood picture and other laboratory findings are required. Usually Bone marrow aspiration (BMA) alone is sufficient for the diagnosis of nutritional anaemias, most of the acute leukaemias and Immune thrombocytopenias. Diagnosis such as Trephine biopsy provides important diagnostic information myelofibrosis, granulomatous disease and bone marrow infiltration. Bone marrow aspiration is useful in making out better individual cell morphology whereas biopsy is useful in bone marrow architectural pattern and distribution. Bone marrow is nor mocellular or hypercellula resulting from ineffective hematopoiesis, increased peripheral destruction and bone marrow invasion. Therefore, bone marrow examination is extremely helpful to identify the cause of pancytopenia. Aim: The main aim of this study is to evaluate the cytological and histological pattern of various hematological disorders in bone marrow aspiration and trephine biopsy respectively. Material and Methods: During the period of 1 year 100 patient with the cases of haematological disorders were included in this study. Routinely stain like Leishman stain is used for bone marrow aspiration. Haematoxylin and eosin stain is also used for trephine biopsy. For all the cases reticulocyte count, peripheral smears, sickling test and complete hemogram were done. Special stains PAS Stain (Periodic acid schiff) was done for all ALL, AML and gauchers disease. In ALL cases Block positivity is shown. In gauchers disease, a gaucher cell shows wrinkled tissue paper appearance with PAS positivity. Reticulin stain was done in myelofibrosis and metastatic deposits. In myelofibrosis, trephine biopsy shows increase in reticulin network with coarse fibrils. Result: In all the cases bone marrow aspiration was done and among them 40 cases trephine biopsy were done. Out of total patients 57 were male and 43 were female.  And the mean age was found as 32.6 years. The findings of the bone marrow were examination. At the time of study period 50% of the study have anemias and they are predominantly megaloblastic followed by aplastic/ hypoplastic anemias. Other three cases include two metastatic deposits and one storage disorder (Gaucher’s Disease). Conclusion: Bone marrow examination is important to diagnosis, prognosis or evaluate therapeutic response for a variety of hematologic and non-hematologic problems. Nowadays, Bone marrow aspiration & bone marrow biopsy are used routinely as diagnostic procedures because it is easier and does not require advance equipments. Therefore both the procedures are complementary to each other which are helpful in further investigation and management. Keywords: Bone marrow aspiration, Trephine biopsy, Pancytopenia, Megaloblastic Anemia


2021 ◽  
Vol 71 (2) ◽  
pp. 672-75
Author(s):  
Sunila Tashfeen ◽  
Naveed Asif ◽  
Shafia Nasir ◽  
Muhammad Azam ◽  
Zareen Irshad

Objective: To determine the frequency of haematological disorders diagnosed by bone marrow examination at a tertiary care centre in Quetta, Balochistan. Study Design: Prospective observational study. Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Jan 2018 to May 2019. Methodology: A total of 101 one patients, who underwent bone marrow examination, were included in the study. Brief history, clinical examination and indication of procedure were also endorsed in a questionnaire designed for the study. Results: Bone marrow of one hundred and one patients, included in the study, were evaluated. Mean age of the patients was 32.3 ± 18.4 years. There were 68 males (67%), while 33 were females (33%) with 2:1 male to female ratio. Pyrexia of unknown origin (PUO) was the most common indication for bone marrow examination with frequency of 20.7%. Nutritional anaemia was the most prevalent benign disorder (17%), whereas Acute Lymphoblastic leukaemia (ALL) accounted about 6.8% which is highest in malignant disorders. Conclusion: This study has concluded that bone marrow examination is a useful technique and findings of bone marrow can modify the treatment. Thus procedure has a great diagnostic value. Both bone marrow aspiration (BMA) and bone marrow biopsy (BMB) are the complimentary techniques and supremacy of one method on other depends on the disorder.


2015 ◽  
Vol 4 (1) ◽  
pp. 12-14
Author(s):  
Nirajan Mainali ◽  
Neha Homagai ◽  
Pratap Sagar Tiwari ◽  
Arun Giri

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


Author(s):  
Subuh Parvez Khan ◽  
Sajad Geelani ◽  
Shareefa Akhter ◽  
Shuaeb Bhat ◽  
Saleem Hussain ◽  
...  

Background: The bone marrow examination is an essential investigation for the diagnosis and management of many disorders of the blood and bone marrow. Bone marrow aspiration (BMA) alone is usually sufficient to diagnose nutritional anaemias, and most of the acute leukaemias. Aim was to study the spectrum of haematological disorders diagnosed on bone marrow aspiration.Methods: This study was conducted in the Department of Clinical Haematology in Sher e Kashmir Institute of Medical Sciences, Kashmir for a period of 2 years from December 2015 to December 2017. Bone marrow examination of 2131 cases of suspected hematological disorders was carried out. Bone marrow was aspirated from posterior superior iliac spine under local anaesthesia. Aspirates of dry tap were excluded from the study. Aspiration smears where stained with Leishmann stain for morphological examination.Results: A total of 2131 cases were included in this study. Male to female ratio in our study was 1.9:1. The age range of cases was from 1-80 years and the mean age was 47.3 years. Anemia was the most common haematological disorder in our study accounting for 25.6% of cases followed by acute leukaemia accounting for 22.3% and multiple myeloma (13.3%). Among anemias, megaloblastic anemia was most common followed by dual deficieny anemia. Among leukaemias, acute myeloid leukaemia (13.2%) was more common than acute lymphoblastic leukaemia (9.1%).Conclusions: Bone marrow aspiration cytology is a mildly invasive technique which can diagnose many hematological and non-hematologic diseases that can be confirmed by more advanced investigations viz. serological, biochemical or molecular. It is a highly informative test procedure performed for evaluating blood and blood related diseases in our environment.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4718-4718 ◽  
Author(s):  
Maria G. Falcon ◽  
Chatchawin Assanasen ◽  
Paul Thomas ◽  
Victor Saldivar

Abstract Abstract 4718 Bone marrow examination is important for the diagnosis of hematological malignancies and nonmalignant diseases in children. In patients with newly diagnosed lymphoproliferative diseases and certain non-hematopoietic malignancies, bone marrow examination is also part of the staging process. Core biopsy length has been found to be critical in diagnosing, predicting relapse or identifying residual disease following chemotherapy in patients. The larger the amount of marrow obtained increases the chance of finding a focal lesion. Unfortunately, the current practice of obtaining trephine biopsies and bone marrow aspirates in children via the manual method has a poor success rate for obtaining adequate specimens. In 2007, an FDA-cleared battery powered bone marrow aspiration and biopsy system (OnControl™ by Vidacare) was developed. Multiple studies have evaluated the use of the powered device in adults and found decreased time of procedure, decreased pain, and improved core biopsy specimens. Here we present a direct comparison of the rotary powered device versus the traditional manual device (e.g. Jamshidi) when obtaining bilateral bone marrow aspirates and biopsies in a 17 year-old female with relapsed alveolar rhabdomyosarcoma. This patient required bilateral bone marrow biopsies to stage her disease and evaluate for bone marrow involvement. One aspirate and biopsy was obtained using the powered device from the right posterior superior iliac crest, and specimens were obtained from the left iliac crest using the traditional manual device. The endpoints measured were quality of the biopsy, length and width of the biopsy, time to obtain aspirate and biopsy, number of attempts to obtain the biopsy, post-procedural pain, and operator satisfaction with the device (O.S.). Device Quality Rating Length (mm) Width (mm) Aspirate Time (sec) Biopsy Time (sec) Attempts Pain Score (0–10) O.S. (0–10) Powered 2 9 1.5 20 108 1 0 10 Manual 1 14 2 25 225 1 0 9 In conclusion, the powered device was superior to the manual device in terms of time to obtain the aspirate and biopsy and operator satisfaction with the device. It was found to be equivalent to the manual device in regards to number of attempts to obtain the biopsy, and post-procedural pain score. The manual device produced a biopsy that was longer, wider, and of higher quality than the biopsy obtained via the powered method. A randomized controlled trial in the pediatric population comparing the rotary powered device to the traditional device is currently underway as further studies are needed to evaluate the use of the powered bone marrow aspiration and biopsy device in children. Disclosures: Falcon: Vidacare Corporation: Research Funding. Assanasen:Vidacare Corporation: Research Funding.


2021 ◽  
pp. 1-3
Author(s):  
Nirali Shah ◽  
◽  
Vidhi Shah ◽  
Falguni Goswami ◽  
Roopam Gidwani ◽  
...  

Introduction: Bone marrow examination is an important diagnostic tool to evaluate various hematological and non-hematological disorders. The two most important techniques used for the diagnosis are bone marrow aspiration and bone marrow biopsy which play complementary role with each other when performed simultaneously. Aims and Objectives: Study was done to compare the results of BMA and BMB and by that to prove the complementary role of both techniques to each other. Material and Methods: We evaluated total 74 cases in central laboratory, department of pathology, at tertiary care centre. All aspirations were stained by giemsa and iron stain while all biopsy were stained by routine H&E stain. Reticulin stain and IHC markers were used as and when required. Result: Out of total 74 cases, 40 cases showed positive corelation between these two techniques (54%). In two cases aspiration was not possible. In 8 cases biopsy was not done. 4 cases showed crushing artefact in BMB while 3 cases of aspiration were either diluted or dry tap. In all these cases diagnosis became possible by the alternate technique. BMB replaced BMA and vice versa as and when required. Conclusion: BMA and BMB are complementary procedure which yields extra support in diagnosing various hematological and non hematological disorders when one or other technique fails due to some reason


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