Critical Analysis Of Bone Marrow Studies - A 5 Year Experience

  • Jerusha Samuela Jacob Department of Pathology,Sri Ramachandra Medical College &Research Institute,Chennai,Tamilnadu,India
  • Febe Renjitha Suman Department of Pathology,Sri Ramachandra Medical College &Research Institute,Chennai,Tamilnadu,India
  • Sai Shalini C.N Department of Pathology,Sri Ramachandra Medical College &Research Institute,Chennai,Tamilnadu,India
  • Rithika Rajendran Department of Pathology,Sri Ramachandra Medical College &Research Institute,Chennai,Tamilnadu,India
  • Ravi Teja J Department of Pathology,Sri Ramachandra Medical College &Research Institute,Chennai,Tamilnadu,India
  • Jesu Magdalene S Department of Pathology,Sri Ramachandra Medical College &Research Institute,Chennai,Tamilnadu,India
Keywords: Bone marrow studies, bone marrow aspirate, bone marrow biopsy, trephine biopsy

Abstract

Introduction:Bone marrow Aspirate (BMA) and bone marrow trephine biopsy (BMB) are the two diagnostic procedures done to evaluate various hematologic and non-hematologic conditions.Though both the procedures done on the same day are complementary to each other, discrepancies do occur. In few instances aspirate alone is done without a biopsy.This study is aimed to statistically analyze the diagnostic value of both the procedures and the lacuna observed.Materials and methods:A retrospective laboratory record based analysis was done on the bone marrow investigations reported during a period of 5 years (Jan.2011 – Dec.2015). The bone marrow investigations with simultaneous BMA and BMB done during the period of study were included.  Descriptive statistical analysis was donefor correlation of BMA and BMB diagnosis.Results:Aspirate and biopsy were done on 934 cases. The diagnostic sensitivity of BMB was 94.74% and BMA was 86.14%.  BMB and BMA were complementary to each other in 53.21% cases.  BMB alone was diagnostic in 33.61% cases and BMA alone was diagnostic in 9.31% cases.  Inadequate material for diagnosis was noted in 8.35% of BMB cases and 27.41% of BMAcases.Good positive correlation was noted in cases of immune thrombocytopenic purpura, multiple myeloma, anemia,reactive marrow and chronic lymphocytic leukemia.Conclusion:Though both the procedures were complimentary to each other, inadequate aspirates due to disease conditions and faulty techniques were major drawbacks. It is preferable to perform both the procedures simultaneously for a more conclusive diagnosis.DOI: 10.21276/APALM.1601

References

1. Islam A. Bone marrow aspiration before bone marrow core biopsy using the same bone marrow biopsy needle: a good or bad practice?. J ClinPathol. 2007;60:212-215.

2. Chandra S, Chandra H. Comparison of bone marrow aspirate cytology, touch imprint cytology and trephine biopsy for bone marrow evaluation. Hematol Rep. 2011;3:65-68.

3. Aljadayeh MH, Saidat SD, Kamal N, Telfah A. Comparative Evaluation between Bone Marrow Aspirate and Biopsy Morphologic Findings, Experience At King Hussein Medical Center. JRMS. 2015;22:18-22.

4. Toi PC, Varghese RB, Rai R. Comparative evaluation of simultaneous bone marrow aspiration and bone marrow biopsy: an institutional experience. Indian J Hematol Blood Transfus. 2010;26:41-44.

5. Mahajan V, Kaushal V, Thakur S, Kaushik R. A comparative study of bone marrow aspiration and bone marrow biopsy in haematological and non haematological disorders–An institutional experience.JIACM. 2013;14;133-135.

6. Khan TA, Khan IA, Mahmood K. Diagnostic role of bone marrow aspiration and trephine biopsy in haematological practice. J Postgrad Med Institute. 2014;28:217-221.

7. Bain BJ. Bone marrow trephine biopsy. J ClinPathol. 2001; 54:737-742.

8. Štifter S, Babarović E, Valković T, Seili-Bekafigo I, Štemberger C, Načinović A, Lučin K, Jonjić N. Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma. Diagnpathol. 2010; 5:30-37.

9. Sitalakshmi S, Srikrishna A, Devi S, Damodar P, Alexander B. The diagnostic utility of bone marrow trephine biopsies. Indian J PatholMicrobiol. 2005; 48:173176.

10. Nanda A, Basu S, Marwaha N. Bone marrow trephine biopsy as an adjunct to bone marrow aspiration. J Assoc Physicians India. 2002; 50:893-895.

11. Kaur M, Rana AP, Kapoor S, Puri A. Diagnostic Value of Bone Marrow Aspiration and Biopsy in Routine Hematology Practice. JCDR. 2014;8:FC13-16.

12. Winfield DA, Polacarz SV. Bone marrow histology. 3: Value of bone marrow core biopsy in acute leukaemia, myelodysplastic syndromes, and chronic myeloid leukaemia. J ClinPathol. 1992;45:855-859

13.MuslinoA,GuazziA,NizzoliR,PanebiancoM,ManciniC,ArdizzoniA.Accuracy and relative value of bone marrow aspiration in the detection of lymphoid infiltration in non – Hodgkin lymphoma.Tumori.2010;96;24-27.

14. .Mishra P, Das S, Kar R, Jacob SE, Basu D. Non-haematopoietic malignancies metastasing to the bone marrow: A 5 year record-based descriptive study from a tertiary care centre in South India. India. Indian J Cancer. 2014;51:30-34 Indian J Cancer. 2014;51:30-34
Published
2018-01-27
Section
Original Article