scholarly journals Bone marrow aspirate and trephine biopsy findings in lymphoplasmacytic lymphoma

2011 ◽  
Vol 86 (3) ◽  
pp. 311-312
Author(s):  
Kikkeri N. Naresh ◽  
Pritesh Trivedi ◽  
Asad Luqmani ◽  
Amin Rahemtulla
2020 ◽  
Vol 10 (04) ◽  
pp. 124-132
Author(s):  
Teresa Lotodo ◽  
Beatrice Melly ◽  
Christopher M. Wanjiku ◽  
Caroline Kilachi ◽  
Austin Omondi ◽  
...  

2015 ◽  
Vol 9 (2) ◽  
pp. 59-63
Author(s):  
Haque Mahfuz ◽  
Md Mizanur Rahman ◽  
Mohammad Nuruzzaman Bhuyain ◽  
Debashish Shaha

Introduction: Examination of peripheral blood film (PBF) and biopsy of the bone marrow are an indispensible adjunct to the study of diseases of the blood and may be the only way in which a correct diagnosis can be made. Marrow can be obtained by needle aspiration, percutaneous trephine biopsy or surgical biopsy. Morphological examination of the bone marrow by an experienced haematologist can provide very useful information important for many haematological and non-haematological disorders. Objective: The aim of the study was to diagnose both haematological and non-haematological disorders by only morphological bone marrow examination in a district town distant from the capital city where sophisticated diagnostic facilities are not available. Methods: This cross sectional type of descriptive study was carried out in Combined Military Hospital (CMH), Jessore and different private and public hospitals. Five hundred cases taken as a non-probability purposive sampling method were included in this study irrespective of age and sex from January 2009 to June 2011. Bone marrow was aspirated from posterior superior iliac spine and first piece of the body of the sternum taking aseptic precautions and after infiltrating local anaesthesia. Only two cases required percutaneous trephine biopsy. After aspiration bone marrow smears were stained and examined under microscope. 59 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 Results: There were 294 (58.8%) male and 206 (41.2 %) female out of 500 cases. The age of the patients ranged from one year to 82 years. Haematological malignancy were 321 cases (64.2%), non-malignant haematological and non-haematological diseases were 112 (22.4%) and 56 (11.2%) cases respectively and normal active marrow were from 11 (2.2%) cases. Among 321 haematological malignancies, Acute Lymphoblastic Leukaemia (ALL) and Acute Myeloblastic Leukaemia (AML) were 126 (39.3%) and 99 (30.8%) respectively and Chronic Myeloid Leukaemia (CML) were 37 (11.5%). Out of 112 non-malignant haematological cases, erythroid hyperplasia was found in 42 (37.5%) cases in which micronormoblastic erythroid hyperplasia was 33 (29.5%) and megaloblastic erythroid hyperplasia was 9 (8.0%) cases. Aplastic anaemia/progressive marrow failure was diagnosed in 40 (35.7%) cases. Two (1.8%) cases were diagnosed as myelofibrosis. Non-haematological diseases were 56 of which 49 (87.5%) cases were secondary reactive marrow & only seven (12.5%) cases were secondary metastatic deposits in the bone marrow. Conclusion: Morphological examination of bone marrow aspirate is a key to the diagnosis of many diseases especially the haematological disorders. Microscopic examination of bone marrow aspirate by an experienced haematologist may solve many diagnostic difficulties faced in day to day clinical practice. Therefore, for the betterment of both patients and physicians more emphasis should be given to become well conversant in reporting a bone marrow aspirate by the haematologists. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21828 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013


Author(s):  
Asfa Zawar ◽  
Shahzad Ali Jiskani ◽  
Maryam Zulfiqar ◽  
Aliena Sohail ◽  
Asma Mustafa ◽  
...  

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.


2005 ◽  
Vol 129 (4) ◽  
pp. 497-501 ◽  
Author(s):  
Farah Moid ◽  
Louis DePalma

Abstract Context.—Bone marrow aspirates as well as bone marrow trephine biopsies are frequently performed to assess whether there is marrow involvement by a malignancy. Numerous reports differ in the relative value of these 2 procedures and fail to provide concise guidelines that can help choose the appropriate technique in this clinical situation. Objective.—To compare the relative value of aspirates and trephine biopsies in the diagnosis of solid tumor metastasis and Hodgkin lymphoma. In addition, we correlate our findings with those of the literature to provide a concise practice guideline. Design.—Sixty-six cases showing bone marrow involvement by solid tumor and Hodgkin lymphoma in bone marrow aspirates, bone marrow trephine biopsies, or both were included in the study. The diagnosis and findings made on aspirates were compared with those made on trephine biopsies in each case. Results.—In those cases where both aspirate and trephine biopsy were available for evaluation, there was a 22% positive correlation in the findings on aspirates and trephine biopsies. The correlation between aspirates and trephine biopsies was highest in cases of small cell carcinoma of the lung (3/11, or 36.3%) followed by breast carcinoma (7/20, or 35%), prostate carcinoma (1/9, or 11.1%), and Hodgkin lymphoma (1/20, or 5%). Two of 5 cases from the miscellaneous category demonstrated simultaneous involvement of aspirate and trephine biopsy by a gastric carcinoma as well as an adrenal gland carcinoma. Conclusions.—Bone marrow aspirate and bone marrow trephine biopsy should both be performed in patients with proven or suspected malignancies where staging may affect management. However, bone marrow aspirate has only a minimal role, if any, in detecting bone marrow involvement by Hodgkin lymphoma. In cases of breast carcinoma, small cell carcinoma of lung, and prostate carcinoma, aspirate evaluation may confirm trephine biopsy results or, more rarely, provide the sole confirmation of the malignancy.


2013 ◽  
Vol 6 (1) ◽  
pp. e2014002 ◽  
Author(s):  
Surbhi Goyal ◽  
Usha Rani Singh ◽  
Usha Rusia

Introduction- Bone marrow examination is an indispensable diagnostic tool to evaluate neoplastic and non neoplastic hematological diseases. Aims- To compare bone marrow aspirate with trephine biopsy in hematological disorders. To determine the optimum trephine preprocessing length in lymphoma infiltration. Methods – Diagnostic comparison was done between simultaneous bone marrow aspirates and trephine biopsies in 449 patients. Biopsies were fixed in formalin, decalcified in 5.5% EDTA and routinely processed. Concordance rates and validity parameters for aspirate were calculated. Three deeper sections of trephine biopsy, cut at 0.1–0.2 mm intervals, were assessed for lymphoma involvement. Proportion of biopsies showing marrow infiltration by lymphoma cells was plotted against trephine length and correlation was assessed. Results- Aspirate had a high sensitivity for acute leukemia (89.4%) and multiple myeloma (88.5%), moderate for NHL (67.6%) and nonhematopoietic metastases (58.3%) and low for aplastic anemia (38.5%) and Hodgkin lymphoma (5%). Aspirate has no role in granulomatous myelitis and myelofibrosis. Lymphoma positivity increased with trephine length, with maximum positivity (68.9%) seen in 17-20 mm group and no further gain beyond 20 mm. (lymphoma positivity ≤16mm=40.3% and ≥17mm=66.1%, p=0.0011). Conclusion- Though aspirate has a high specificity, sensitivity depends upon the type of disease. Apart from few conditions, in which aspirate alone is sufficient, biopsy is mandatory in most. Preprocessing trephine length of 17-20 mm examined at multiple deeper levels was found optimal for assessing lymphoma positivity.


2018 ◽  
Vol 5 (3) ◽  
pp. 608 ◽  
Author(s):  
Nusrat Bashir ◽  
Bilal Musharaf ◽  
Ruby Reshi ◽  
Tazeen Jeelani ◽  
Danish Rafiq ◽  
...  

Background: Bone marrow aspiration and trephine biopsy are two most important techniques which are complementary for diagnosing both neoplastic and non- neoplastic haematological diseases. The present study was conducted in the department of pathology to compare the role of bone marrow aspirate and trephine biopsy for diagnosing the haematological diseases.Methods: The study was conducted in the department of pathology government medical college Srinagar over a period of 2 years from Feb 2016 to Jan 2018. The study was one-year retrospective and one year prospective. Bone marrow aspiration was done in 626 cases out of which biosy was done in 300 cases.Results: Out of the selected 300 cases were both aspiration and trephine biopsy were available, diagnostic material on bone marrow aspirate was adequate in 288 cases. 12 cases were aparticulate. Biopsy was inadequate in 8 cases. Overall megaloblastic anaemia (26.6%) was most common followed by dual deficiency anemia. Multiple myeloma was the most common neoplastic pathology (13%) followed by followed by acute leukaemia’s (6%) and Chronic lymphoproliferative disorders (CLPDS) (5%). 1 case each of visceral leishmaniasis and malarial parasite were also noted. 4 cases (1.3%) of granulomatous pathology and 2 cases (0.6%) of Hodgkins lymphoma were diagnosed exclusively on bone marrow biopsy.Conclusions: Bone marrow aspiration and biopsy are complimentary to each other in diagnosing hematological disorders with biopsy being gold standard in the assessment of cellularity, pattern, extent of tumor infiltration and focal infiltration. It is more helpful in diagnosing granulomatous pathology and metastatic deposits of tumors eliciting fibrotic response.


2008 ◽  
Vol 61 (9) ◽  
pp. 1051-1054 ◽  
Author(s):  
G Chakupurakal ◽  
J Delgado ◽  
E Nikolousis ◽  
S Pitchapillai ◽  
D Allotey ◽  
...  

Aim:To compare intravenous titrated midazolam 5–10 mg and inhaled Entonox in addition to local anaesthesia in order to identify which agent provides optimum pain relief.Methods:Randomised, controlled trial. 49 patients were recruited, of which 46 were evaluable. 24 and 22 patients were recruited into the Entonox and midazolam arms, respectively. Patient experiences as well as staff observations were recorded with questionnaires after recovery from the procedure and 24 hours later.Results:45% and 59% of the patients in the midazolam arm could recollect the procedure after 15 minutes and 24 hours, respectively, compared to 96% and 88% who received Entonox. Midazolam provided a more comfortable experience (p<0.01) and improved pain relief (p = 0.01) compared to Entonox immediately after the procedure; this further improved when recalled 24 hours later. Nausea, dizziness and hallucinations were observed with both treatments, but dizziness was significantly more frequent with Entonox (p = 0.048). Clinically relevant respiratory depression (O2 saturation <90%) occurred in 19% of patients in the midazolam arm; sedation was reversed with flumazenil.Conclusion:Midazolam in conjunction with local anaesthesia provides rapid and reversible sedation as well as effective pain relief during bone marrow biopsy, and is superior to Entonox; however, care must be taken to monitor respiratory function.


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