EVALUATION OF MACROCYTOSIS IN PATIENTS OF BIHAR

INTRODUCTION- Macrocytosis is a relatively common nding in routine CBC and peripheral blood smear. It is divided into two groups– megaloblastic and non-megaloblastic groups based on morphological and biochemical ndings. MATERIALS AND METHODS-We conducted this study in the department of pathology, Nalanda medical college, Patna, Bihar over a period of 18 months (September 2018 to March 2020). Sixty adult patients (>18 years) with macrocytosis (MCV>100) were evaluated in our study. Various tests were done to establish the cause of macrocytosis. RESULT– The most common cause of macrocytosis was megaloblastic anemia due to vitamin B deciency (53.3%). Non-megaloblastic anemia 12 was caused by liver disorder (18.33%) followed by primary bone marrow disorders (10%). CONCLUSION- The commonest cause of macrocytosis is megaloblastic anemia, but there are multiple non-megaloblastic causes with different mechanism and different treatment approach. Early detection of macrocytosis and its etiology helps in proper management of the patient with better outcome.

Immunoexpression of CD34, CD117, and p53 in Hypocellular Bone Marrow Disorders

Objectives Hypocellular bone marrow (BM) disorders comprise heterogeneous entities associated with peripheral cytopenias and decreased production of hematopoietic cells in BM. This study was undertaken to analyze immunohistochemical expression of CD34, CD117, and p53 in morphologically diagnosed patients of hypocellular BM (aplastic anemia [AA], hypocellular myelodysplastic syndrome [h-MDS], and hypocellular acute myeloid leukemia [h-AML]). Materials and Methods BM specimens were obtained from patients presenting with pancytopenia/bicytopenia. On 30 patients diagnosed as hypocellular BM, immunohistochemistry (IHC) for CD34, CD117, and p53 was performed. Results BM cellularity was < 30% in all (100%) patients. Blast count was increased in h-MDS and h-AML. Features of dysplasia were noted in six (20%) patients. Out of these, three patients were diagnosed as h-MDS having bilineage/trilineage dysplasia, and the other three patients were of AA (11.5% patients) displaying only dyserythropoiesis. On IHC, percentage of BM CD34+ cells was increased in h-MDS+ h-AML (3.87 ± 0.86) as compared with AA (0.19 ± 0.15) and controls (0.81 ± 0.21), p = 0.01. Percentage of BM p53+ cells was also increased in h-MDS+ h-AML (2.9 ± 2.07) as compared with AA and controls, which did not show any p53+ cells, p = 0.0. No statistically significant difference was observed in the expression of CD117 in h-MDS+ h-AML (4.95 ± 3.40) compared with AA (4.49 ± 1.07), p = 0.99. Conclusion The study demonstrates the usefulness of CD34 and p53 immunoexpression as an important ancillary method in distinguishing various hypocellular BM disorders, especially h-MDS and AA. However, the role of CD117 remains unclear and needs to be evaluated further by larger studies.

Retrospective study of 152 feline cytological bone marrow examinations: preliminary classification and ranges

Objectives Cytological assessment of the bone marrow is an essential tool for understanding and investigating haematological abnormalities. Sometimes it represents the only way to reach a definitive diagnosis. The purpose of this study was to provide a general overview regarding the prevalence of feline bone marrow disorders encountered in a private European laboratory setting, to classify them and to assess the differential cell counts related to such disorders. Methods In total, 152 bone marrow samples were classified using cytological and numerical criteria. The bone marrow cytological examinations were performed after the identification of haematological alterations, such as cytopenias, increased number of cells or suspicion of malignant blood disorders. Results Of the 152 bone marrow samples evaluated, 71 (46.7%) were classified as hyperplastic, primarily granulocytic and erythroid hyperplasia (50.7% and 45.1%, respectively, of the total hyperplasia); 23 (15.1%) showed dysmyelopoiesis, mainly in the form of myelodysplastic syndrome (39.1% of the total dysmyelopoiesis); 21 (13.8%) had no cytological abnormalities; 17 (11.2%) were malignant blood disorders; 15 (9.9%) had hypoplastic conditions; and two (1.3%) were miscellaneous diseases. Metastatic disease was detected in only two cases (1.3%). Differential cell counts and myeloid-to-erythroid (M:E) ratios were reported for normal, erythroid hypoplastic, erythroid and granulocytic hyperplastic and dysplastic conditions. Conclusions and relevance This study provides a general overview of the prevalence and incidence of feline bone marrow disorders together with ranges for differential nucleated cell counts and M:E ratios for the various conditions reported.