Bone Marrow Aspiration Cytology: An Important Diagnostic Tool for Hematological Disorders

2019 ◽  
Author(s):  
Amin Alamin
Keyword(s):  
Bone Marrow ◽  
Diagnostic Tool ◽  
Bone Marrow Aspiration ◽  
Aspiration Cytology ◽  
Hematological Disorders ◽  
Important Diagnostic Tool

scholarly journals Complementry Role of Bone Marrow Aspiration and Biopsy

2021 ◽  
pp. 1-3
Author(s):  
Nirali Shah ◽  
◽  
Vidhi Shah ◽  
Falguni Goswami ◽  
Roopam Gidwani ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Central Laboratory ◽  
Tertiary Care Centre ◽  
Hematological Disorders ◽  
Complementary Role ◽  
Important Diagnostic Tool

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

scholarly journals DIAGNOSTIC IMPORTANCE OF BONE MARROW ASPIRATION IN HEMATOLOGICAL DISORDERS – TERTIARY CARE CENTRE BASED STUDY.

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Seema Meena ◽  
Sukriti . ◽  
Sonal Bhati ◽  
Abha Patni
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Deficiency Anemia ◽  
Invasive Technique ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Hematological Disorders

Background: Bone marrow aspiration (BMA) is a minimally invasive technique performed in a variety of hematological disorders. It is considered essential for the diagnosis and management of haematological disorders. BMA is usually sufficient to diagnose nutritional anemia and most of the leukemias. Aims & Objectives: To study the spectrum of hematological disorders diagnosed on BMA in a tertiary care centre, Udaipur. Material & Methods:  The present study was conducted in the hematology section of department of Pathology, RNT Medical College & MB Hospital, Udaipur for a period of one year from June 2018 to May 2019. A total of 123 cases of suspected hematological disorders underwent the process of BMA from posterior superior iliac spine under local anesthesia. Exclusion criteria of our study included aspirates of dry tap. BMA smears were stained with Giemsa stain for morphologic examination. Result: The present study included 123 cases. Male to female ratio in our study was 1.6:1. Anemia (45.5%) was the most common hematological disorder in our study, iron deficiency anemia being the most common followed by megaloblastic anemia. Chronic myeloid leukemia (26.01%) was the most common hematological malignancy in our study. Conclusion: Bone marrow aspiration is a useful diagnostic procedure in hematological practice for the diagnosis of both hematological and non-hematological conditions. Rapid and early diagnosis of malignancies are critical for proper initiation of treatment and to control the disease. Keywords: Bone Marrow Aspiration, Hematological disorders, Leukemias

A comparative study of bone marrow aspirate with trephine biopsy in pancytopenia disorders

2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK
Keyword(s):  
Bone Marrow ◽  
Sensitivity And Specificity ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Trephine Biopsy ◽  
Hematological Disorders ◽  
Hematoxylin And Eosin

Pancytopenia is commonly reported in clinical hematology practice. Due to its varied marrow pathology and underlying ailments, diagnosis is often misleading and delayed. Bone marrow examination would provide a comprehensive diagnosis of both blood and bone marrow, since aspirate investigates the cytological morphology and biopsy evaluates the cellularity, architecture, and compact marrows.To compare bone marrow aspiration and trephine biopsy results in the diagnosis of pancytopenia, and to determine the sensitivity and specificity of aspirate examination in pancytopenia diagnosis.This prospective study was conducted at a tertiary care hospital from July 2014 to June 2016. A total of 320 samples were received at the department of pathology for bone marrow examination (aspirate and biopsy). Romanowsky (Leishman) stain was used to investigate aspirate samples. All biopsy samples were processed into 3-5 μ blocks and stained using hematoxylin and eosin after decalcification with 5.5% EDTA. Data analysis was performed using SPSS19.Pancytopenia constituted 56 (18.7%) cases with the mean age of 41.79 years. Of the total pancytopenia cases, hematological disorders constituted 50 (89.3%) cases and 6 (10.7%) were non-hematological cases. Aspirate and biopsy diagnosis positively correlated in 76.79% of cases. A 100% sensitivity and specificity of aspirate diagnosis was observed in, acute myeloid leukemia, hypersplenism, myelodysplastic syndrome, megaloblastic anemia, hematological malignancy in remission and negative for lymphoma infiltrate. Aspirate had no role in diagnosis of uremic osteodystrophy and myelofibrosis, whereas leishmaniasis was diagnosed on aspirate alone.Pancytopenia includes multiple underlying ailments which requires a differential diagnosis approach. Combining both aspirate and biopsy for diagnosis would benefit the patient in prognosis as they are complementary to each other.

scholarly journals Comparison of bone marrow aspiration cytology with bone marrow trephine biopsy histopathology: An observational study

2017 ◽  
Vol 9 (03) ◽  
pp. 182-189
Author(s):  
Meenu Gilotra ◽  
Monika Gupta ◽  
Sunita Singh ◽  
Rajeev Sen
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Final Diagnosis ◽  
Trephine Biopsy ◽  
Additional Advantage ◽  
Hematological Disorders ◽  
Bone Marrow Trephine ◽  
Bone Marrow Trephine Biopsy ◽  
Underlying Disorder

Abstract INTRODUCTION: Bone marrow examination is a useful investigative tool for the diagnosis of many hematological and nonhematological disorders. Bone marrow aspiration (BMA) provides information about the numerical and cytological features of marrow cells, whereas bone marrow trephine biopsies (BMB) provide excellent appreciation of spatial relationships between cells and of overall bone marrow structure. We conducted this study with the objective of comparing the accuracy of BMA with BMB in the diagnosis of various hematological disorders. MATERIALS AND METHODS: Both BMA and BMB were performed on a total of 130 cases and a comparative evaluation was performed in 100 cases to see the complementary role of both the procedures. However, 30 cases were excluded due to inadequate BMA, BMB, or both. Immunohistochemistry (IHC) was employed whenever required. RESULTS: In our study of 100 cases, 87% of cases were confirmed on bone marrow biopsy and in remaining 13% of cases final diagnosis was achieved with the help of other ancillary investigations. These cases were excluded for calculation of concordance rate between BMA and BMB. The concordance and disconcordance rate between BMA and BMB was 72.4% and 27.6%, respectively. CONCLUSION: BMA cytology and trephine biopsy histopathology complement each other and the superiority of one method over the other depended on the underlying disorder. Furthermore, application of ancillary techniques such as flow cytometery and IHC proved to be an additional advantage in further typing of various diseases.

scholarly journals BONE MARROW STUDY IN CASES OF HAEMATOLOGICAL DISORDERS

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Atul C. Mujumdar ◽  
Dr. Akash C Chhabra
Keyword(s):  
Bone Marrow ◽  
Peripheral Blood ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Parasitic Infections ◽  
Trephine Biopsy ◽  
Blood Picture ◽  
Hematological Disorders ◽  
Tissue Paper ◽  
Haematological Disorders

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

scholarly journals A prospective study on morphological alteration of megakaryocytes amongst megaloblastic anemia cases along with their clinic-haematological manifestations

2017 ◽  
Vol 5 (9) ◽  
pp. 4127
Author(s):  
Benazeer Mansuri ◽  
Komal P. Thekdi
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Bone Marrow Aspiration ◽  
Morphological Alteration ◽  
Age Group ◽  
Female Ratio ◽  
Hematological Disorders ◽  
Common Complaint ◽  
A Prospective Study ◽  
Male To Female

Background: Megaloblastic anemias are hematologic disorders in which abnormal DNA synthesis causes blood and bone marrow disorders. The cause of thrombocytopenia in megaloblastic anemia has been postulated as hypoproduction in some studies, whereas ineffective thrombopoeisis has been proposed in other. Objective was to study spectrum of clinic-hematological features in megaloblastic anemia and comparative bone marrow aspiration study of thrombocytopenia secondary to megaloblastic anemia, hypoproduction and hyper-destruction. This study was done to understand the various megakaryocytic alterations in hematological disorders presenting with thrombocytopenia due to different mechanisms.Methods: Total 85 cases of thrombocytopenia included in the study. Bone marrow finding in 33 cases of thrombocytopenia of megaloblastic etiology were compared with 34 cases of marrow proven hypo productive thrombocytopenia (aplastic anemia, acute leukemia) and 19 cases of hyper destructive thrombocytopenia (immune thrombocytopenia).Results: Most common age group presenting megaloblastic anemia is 11-20 year, with male to female ratio is1.2:1, most common complaint were generalized weakness and fever. In megaloblastic anemia 24.33%, 60% and 15.67% of the cases shows increase, decrease and normal megakaryocytes respectively. Dysplastic megakaryocytes were observed in 24.3%, 27% and 20.5% of the cases of megaloblastic anemia, acute leukaemia and immune thrombocytopenic purpura respectively.Conclusions: Both hypoproduction and ineffective thrombopoiesis are the underlying path mechanisms in megaloblastic thrombocytopenia as evidenced by the marrow findings. We hereby infer that megaloblastic thrombocytopenia is to be included as a separate category apart from hypo proliferative and hyper destructive groups. The presence of dysplastic megakaryocyte should not prompt an interpretation

scholarly journals Circulating and bone marrow myeloid cells containingLeishmaniaamastigotes in a case of advanced canine leishmaniosis

2019 ◽  
Vol 31 (5) ◽  
pp. 726-731
Author(s):  
Ioannis L. Oikonomidis ◽  
Theodora K. Tsouloufi ◽  
Mathios E. Mylonakis ◽  
Dimitra Psalla ◽  
Nectarios Soubasis ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Weight Loss ◽  
Blood Smear ◽  
Bone Marrow Aspiration ◽  
Buffy Coat ◽  
Routine Practice ◽  
Canine Leishmaniosis ◽  
Aspiration Cytology ◽  
Blood Smears ◽  
Leishmania Amastigotes

A 5-y-old male Poodle mix was presented with intermittent vomiting, anorexia, and weight loss. Physical examination revealed emaciation, lethargy, dehydration, hypothermia, respiratory distress, and splenomegaly. Based on clinicopathologic, serologic, and parasitologic findings, diagnoses of severe leishmaniosis and dirofilariasis were made. Extracellular, intraneutrophilic, and intramonocytic Leishmania amastigotes were observed on blood smear and buffy coat smear examination. In blood smears, 0.2% of neutrophils were observed to be infected; in buffy coat smears, 0.5% of neutrophils and 0.1% of monocytes were found to be infected. Leishmania amastigotes were also found engulfed by eosinophils and neutrophil precursors in bone marrow aspiration cytology. The detection of Leishmania amastigotes in blood smears is rare, and the clinical significance is uncertain. In circulating blood, Leishmania amastigotes are primarily found phagocytized by neutrophils. Although debatable, there is growing evidence that neutrophils are used as carriers enabling the “silent entry” of the protozoa into macrophages (“Trojan horse” theory). To date, cytologic screening of blood smears for the diagnosis of canine leishmaniosis is not a routine practice. Clinical pathologists and practitioners should be aware that Leishmania amastigotes may be present in neutrophils and less frequently monocytes during blood smear evaluation; neutrophil precursors and eosinophils may also be parasitized in bone marrow specimens.

scholarly journals A comparative evaluation of bone marrow biopsy and bone marrow aspiration in different haematological condition with special reference to leukaemia and lymphoma

2020 ◽  
Vol 8 (8) ◽  
pp. 2886
Author(s):  
Nidhi Verma ◽  
Priya Gupta ◽  
Amod Kumar Saroj ◽  
Preeti Singh ◽  
Veer Karuna
Keyword(s):  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Special Reference ◽  
Bone Marrow Biopsy ◽  
Bone Marrow Aspiration ◽  
Clinical History ◽  
Aspiration Cytology ◽  
Medical College ◽  
Cytological Picture ◽  
Haematological Disorders

Background: For diagnosis of haematological disorders there are three modalities to examine bone marrow, bone marrow aspiration cytology (BMA), bone marrow imprint (BMI) and bone marrow biopsy (BMB). BMA gives cytological picture; BMI also gives cytological picture but cells are less in number and BMB gives cytological as well as architectural picture. BMA alone may not be sufficient to reach diagnosis therefore the present study was undertaken to compare the above modalities. The study was conducted with the aim to perform cytomorphological evaluation of bone marrow in various haematological disorders with special reference to leukaemia and lymphoma and to compare bone marrow aspiration smears with bone marrow trephine biopsy.Methods: The present study was conducted in department of pathology, LLRM Medical College, Meerut inpatients attending the outpatient department and in-patient department of pediatrics and medicine of SVBP Hospital attached to LLRM Medical College, Meerut, over a period of one year i.e. from March 2018 to May 2019. A detailed clinical history, physical examination and laboratory examination of all the cases was done.Results: Out of 50 cases, maximum number of cases were of anemia 26/50 (52%) followed by leukemia 17/50 (34%), lymphoma 5/50 (10%), multiple myeloma 1/50 (2%), myelofibrosis 1/50 (2%), leishmaniasis 1/50 (2%) and idiopathic thrombocytopenic purpura 1/50(2%). BMA smears were compared with biopsy and concordance and discordance was established. The overall diagnostic accuracy of aspiration was 94%.Conclusions: Bone marrow examination is a safe, quick easy and cost-effective procedure with very less patient discomfort. BMA shows better cellular details when compared to BMI and BMB. BMB is diagnostic investigation in dry tap cases like aplastic anemia, myelofibrosis, myelodysplastic syndrome and metastatic tumors. In present study, concordance between BMA and BMB was seen in majority of the cases and diagnostic accuracy was 94% study concludes that bone marrow aspiration cytology and trephine biopsy complement each other and should be performed simultaneously for complete bone marrow work up and evaluation.

scholarly journals Study of megakaryocytes in bone marrow aspiration smears in patients with thrombocytopenia

2013 ◽  
Vol 3 (6) ◽  
pp. 476-481 ◽  
Author(s):  
PK Choudhary ◽  
SK Sing ◽  
RB Basnet
Keyword(s):  
Bone Marrow ◽  
Acute Leukemia ◽  
Myelodysplastic Syndrome ◽  
Megaloblastic Anemia ◽  
Hematological Parameters ◽  
Bone Marrow Aspiration ◽  
Common Occurrence ◽  
Thrombocytopenic Purpura ◽  
Hematological Disorders ◽  
Mere Presence

Background: Dysplastic changes in megakaryocyte are well-recognized features of myelodysplastic syndrome. However, several studies have shown it’s occurrence in various other disorders. This study was done to understand the various megakaryocytic alterations including the dysplastic forms in hematological disorders presenting with thrombocytopenia other than in myelodysplastic syndrome. Materials and Methods: All cases of thrombocytopenia in the study period of May 2010 to April 2012 were included. Bone marrow aspiration study was done in each case of thrombocytopenia. Megakaryocytes were examined in bone marrow aspiration smears in terms of their number and morphology. Dysplasia was considered significant if ≥ 10% of megakaryocyte examined show dysplastic morphology. Results: Dysplastic megakaryocytes were observed in 52.3%, 50% and 21.2% of the cases of megaloblastic anemia, acute leukemia and immune thrombocytopenic purpura respectively. Most common dysplastic feature observed were multiple separate nuclei (25.2%) and micromegakaryocyte (17.3%). Hypogranular form was the least observed dysplastic feature (1.4%; 2/139 cases). Conclusion: Dysplasia in megakaryocyte is a quiet common occurrence in various non-myelodysplastic syndroms related thrombocytopenia. The mere presence of dysplastic megakaryocyte should not prompt an interpretation of myelodysplastic syndroms and should always be correlated with patient’s clinical and other hematological parameters. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8997   Journal of Pathology of Nepal (2013) Vol. 3, 476-481

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