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Various indications for bone marrow examination Figure 2: Concordance rates for different hematological disorders
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Background: Bone marrow examination is crucial diagnostic modality for evaluation of various hematological and nonhematological disorders. However, marrow aspirate smears and biopsy sections, even though performed simultaneously, are often assessed at different points of time due to different processing methods. This sometimes results in discordanc...
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A dry tap obtained on bone marrow aspiration is considered a failure to aspirate marrow particles. However, it is often related to an underlying bone marrow pathology that hinders successful aspiration of hematopoietic cells. In this retrospective analysis, 2768 bone marrow aspirates and trephine biopsies were reviewed. Of these, 223 patients with...
Citations
... BMA is a simple and rapid method for assessing marrow, offering outstanding visualization of cell morphology. Conversely, trephine biopsy delivers more detailed insights into marrow cellularity, trilineage hematopoiesis, and the structural layout of infiltrative marrow disorders [5]. ...
... However, bone marrow aspiration smears and biopsy sections even though perform simultaneously are often assessed at different point of time. 3 Bone marrow biopsy is a lengthy process and bone marrow aspiration is a rapid technique for malignancy evaluation. Most of the time, the results of bone marrow aspiration and bone marrow biopsy are concordant but the disparity is also seen in certain cases. ...
... It is similar to the study done by Puri et al where highest concordance rate was encountered in acute leukemia, CML and CLL. 3 Dogan et al also found similar results in their study. 1 Among myeloproliferative disorders except CML, out of 6 cases of essential thrombocythemia, simultaneous BMA and BMB was done in 3 cases which showed 100% concordance. ...
Background: The bone marrow examination is a useful and cost-effective diagnostic procedure in haematological practice for the diagnosis of haematological disorders. It may either confirm the clinically suspected disease or may provide the previously unsuspected diagnosis. The bone marrow examination can be done by bone marrow aspiration as well as by performing bone marrow biopsy. The aim of the study is to compare the diagnostic accuracy and rate of concordance between two modalities of bone marrow examination in diagnosis of haematological malignancies. Methods: The study was conducted at haematology section of the Department of Pathology, Government Medical College, Jammu spanned over a period of 2.5 years from June 2020 to December 2022. The clinical data along with physical examination, relevant haematological, biochemical and radiological investigations were also reviewed. After taking the informed consent bone marrow aspiration and bone marrow biopsy were done under aseptic precautions. Results: A total of 250 cases of haematological malignancies were studied over a 2.5 year period. The most common haematological malignancy was found to be leukemia 194 (77.6%) cases, followed by plasma cell dyscrasia with 30 (12%) cases, lymphomas and myeloproliferative disorders each with 11 (4.4%) cases and metastatic deposits 4 (1.6%) cases. In the present study, 64/250 (25.6%) patients underwent BMA and trephine biopsy simultaneously. A positive concordance was seen in 46 (71.8%) of the cases between the two methods and diagnostic discordance was observed in 10 (16.3%) of the cases. Conclusions: Bone marrow aspiration and biopsy both complement each other and should be evaluated simultaneously. This study emphasizes the need for greater vigilance in the early diagnosis and an interdisciplinary approach for the effective management of patients as well as inclusion of trephine biopsy as regular procedure for complete evaluation of patients with haematological malignancies.
... In this study, the highest overall concordance rates between BMA and BMB were CLL, CML and acute leukemias, which were similar to the rates in our study. 10 In our study, the diagnostic correlation between BMA and BMB was high at 91.2% among the 500 patients included in the sample. In hematological malignant diseases such as acute leukemia, chronic leukemia, and multiple myelomas, the success of BMA was even higher, and the diagnostic agreement between BMA and BMB was 100%. ...
... Thus, in this study and in our study, BMA examination was found to be an effective diagnostic method in remission assessment. 10 Although cell morphologies were adequately evaluated with BMA, in malignancies with focal Ali Dogan et al. involvement, such as lymphoma and multiple myeloma, the diagnosis is made based on BMB when there are not sufficient particles with aspiration or diagnostic cells. 12,13 In our study, the results of BMA and BMB were fully consistent in the diagnosis of 44 (8.8%) patients with multiple myeloma. ...
Background & objective:
Early diagnosis can be made based on the morphological examination of bone marrow aspiration (BMA) until the bone marrow biopsy (BMB) result is reported. This allows for treatment to be started immediately, especially in hematological malignancies for which urgent treatment is indicated. This study aimed to determine the sensitivity and importance of bone marrow aspiration in the diagnosis of hematological malignancies.
Methods:
In this study, the data of patients who underwent bone marrow aspiration and bone marrow biopsy in Van Yuzuncu Yil University hospital between 2017 and 2019 were retrospectively analyzed. A total of 500 patients who simultaneously underwent BMA and BMB were included in the study. Data were obtained from electronic medical records.
Results:
Indication for bone marrow evaluation was abnormalities in complete blood count in 270 (54%) of patients. The diagnosis was made based on the evaluation of BMA in 475 (95%). In 456 (96%) of the 475 patients diagnosed with BMA, the diagnosis was consistent with that of BMB. Agreement of BMB with BMA was 100% in acute and chronic leukemias, while BMA was not sufficient for the diagnosis of lymphoma and solid organ metastasis.
Conclusion:
Our study showed that the evaluation of BMA was highly sensitive in the diagnosis of hematological malignancies, such as acute leukemias, chronic leukemias, and multiple myeloma.
... [2] Bone marrow biopsy (BMB), a tedious procedure, also plays a very important role in cases of dry tap in conditions like myelofibrosis, hairy cell leukaemia and aplastic anemia or dilution aspirate by blood. [3] This study aims to discuss the findings of bone marrow aspirates and biopsy and their correlation with other clinical and laboratory parameters. ...
Aims: The study was conducted with an aim to assess the diagnostic importance of bone marrow aspirate and biopsy examination to reach the final diagnosis in clinically diagnosed and undiagnosed cases of both haematological and non-haematological disorders.
Methods and Material: A prospective study was conducted to correlate the findings of bone marrow examination with clinical parameters. The study included 42 patients, in whom bone marrow evaluation was carried out in the form of bone marrow aspirate and marrow biopsy. Cases, where both aspirate and biopsies were inadequate for opinion, were excluded from the study.
Results: A total of 42 cases were studied after excluding inadequate samples. The majority of cases were in the age group 30 to 50 years, with male preponderance. The most common finding was nutritional anaemia; the features of both megaloblastic and iron deficiency anaemia were seen in 38.1% of cases; iron deficiency was seen in 11.9% cases and 7.1% cases showed megaloblastic anaemia. Leukaemia (both acute and chronic) were seen in 4.8% of the cases. Other cases were necrotizing granulomatous inflammation of bone marrow, aplastic anaemia, metastasis to bone marrow, plasma cell dyscrasias, ITP, the gelatinous transformation of marrow, hemophagocytic lymphohistiocytosis, congenital dyserythropoietic anaemia and myelofibrosis etc.
Conclusions: The correlation of morphological findings of bone marrow aspirate and biopsy with other clinical and pathological features can aid in the diagnosis of cases that have been missed clinically.
... Examination of bone marrow samples is an important test to make diagnosis of a wide spectrum of hematological diseases. [1][2][3][4][5] There are a number of diseases that cannot be diagnosed without doing bone marrow biopsy. [6][7][8][9][10][11] It is the first investigation done if patient has unexplained cytopenias or hepatosplenomegaly. ...
... The aspirate sample helps determine the morphology of cells of each lineage, cell counts, adequacy of megakaryocytes, and detection of iron stores in macrophages. 1,3,[13][14][15] The trephine is useful for assessing the framework of the bone marrow and determination of pattern of infiltration of the marrow by atypical or metastatic mononuclear cells, in addition to cellularity. 1,3,[13][14][15] Both are diagnostically important. ...
... 1,3,[13][14][15] The trephine is useful for assessing the framework of the bone marrow and determination of pattern of infiltration of the marrow by atypical or metastatic mononuclear cells, in addition to cellularity. 1,3,[13][14][15] Both are diagnostically important. 15 When both are done together, they complement each other, and thus guide the hematologist to a particular diagnosis with more accuracy. ...
Objective: To compare diagnostic value of bone marrow aspiration and bone marrow trephine in reaching to final diagnosis. Study Design: Cross Sectional Descriptive study. Setting: Pathology Department of Khyber Teaching Hospital, Peshawar. Period: December 2015 to September 2016. Material & Methods: About 199 bone marrow procedure were done during study period. Nine cases were excluded because their trephine biopsy specimen was not available. So, the remaining 190 cases, of both the sexes and age above 2 years were included. Bone marrow aspiration and trephine biopsy were obtained from all the patients, and examined. Qualitative data was determined by frequency and percentages. Quantitative data was shown by mean and standard deviation. Results: 190 cases were included in the study. The mean age of the sample was 40 ±11.5 SD years (range: 2 to 81 years). Bone marrow aspirate alone could diagnose 139 (72.8%) cases while trephine biopsy alone was sufficient to diagnose 12 (6.3%) cases. Both the modalities showed similar diagnosis in 39 (20.9%) cases. Conclusion: Leukemias, anemias, and idiopathic thrombocytopenic purpura can be diagnosed by marrow aspiration alone. Aplastic anemia and myelofibrosis need marrow trephine for diagnosis. Both these modalities are important lest any diagnoses should be missed.
... It was defined by the disruption of more than 50% of the bone marrow architecture with the necrosis of the stroma and myeloid tissue without cortical bone involvement. 1 Bone marrow examination is considering the cornerstone in diagnosing and assessing hematological disorders as in marrow necrosis. 2 The diagnosis of BMN usually confirmed during the postmortem period, but it should be highly suspected in those cases with severe BM failure with febrile neutropenia. 3 A granulocyte-colony stimulation factor (GCSF) is considered an essential part of the management of febrile neutropenia. ...
IntroductionBone marrow necrosis (BMN) is considered a rare condi-tion that occurs mainly in hematological and sometime innon-hematological disorders. It was defined by the disrup-tion of more than 50% of the bone marrow architecturewith the necrosis of the stroma and myeloid tissue with-out cortical bone involvement.1Bone marrow examinationis considering the cornerstone in diagnosing and assessinghematological disorders as in marrow necrosis.2BMN causedby high dose chemotherapy given for the management of∗Corresponding author at: Clinical Hematology, National Center of Hematology, Mustansiriyah University, Hay Alqadisiya, Section 602,Bagh, Street 14, Baghdad 10001, Iraq.E-mail address: ala sh73@yahoo.com (A.F. Alwan).some leukemia. The diagnosis of BMN usually confirmedduring the post-mortem period, but it should be highly sus-pected in those cases with severe BM failure with febrileneutropenia.3A granulocyte-colony stimulation factor (GCSF) is con-sidered an essential part of the management of febrileneutropenia. GCSF helps to decrease the duration of admis-sion following myeloablative chemotherapy protocol.4Fewcases of BMN have been reported, mainly in acute leukemiaeither during induction chemotherapy or during condi-tioning protocol for autologous or allogeneic stem celltransplantation
