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CC BY-NC-ND 4.0 · J Lab Physicians 2017; 9(03): 182-189
DOI: 10.4103/JLP.JLP_117_16
Original Article

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

Meenu Gilotra
Department of Pathology, Pt. BDS, PGIMS, University of Health Sciences, Rohtak, Haryana, India
,
Monika Gupta
Department of Pathology, Pt. BDS, PGIMS, University of Health Sciences, Rohtak, Haryana, India
,
Sunita Singh
Department of Pathology, Pt. BDS, PGIMS, University of Health Sciences, Rohtak, Haryana, India
,
Rajeev Sen
Department of Pathology, Pt. BDS, PGIMS, University of Health Sciences, Rohtak, Haryana, India
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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.

Keywords

Aplastic anemia - bone marrow aspiration - bone marrow biopsy - megaloblastic anemia


Publication History

Received: 28 August 2016

Accepted: 11 January 2017

Article published online:
19 February 2020

© 2017.

Thieme Medical and Scientific Publishers Private Ltd.
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  • References

  • 1 Bain BJ. Bone marrow aspiration. J Clin Pathol 2001;54:657-63.
  • 2 Bain BJ. Bone marrow trephine biopsy. J Clin Pathol 2001;54:737-42.
  • 3 Riley RS, Hogan TF, Pavot DR, Forysthe R, Massey D, Smith E, et al. A pathologist's perspective on bone marrow aspiration and biopsy: I. Performing a bone marrow examination. J Clin Lab Anal 2004;18:70-90.
  • 4 Bates I, Burthem J. Bone marrow biopsy. In: Bain BJ, Bates I, Laffan MA, Lewis SM, editors. Dacie and Lewis Practical Hematology. 11th ed. China: Elsevier, Churchill Livingstone; 2012. p. 123-37.
  • 5 Atla BL, Anem V, Dasari A. Prospective study of bone marrow in haematological disorders. Int J Res Med Sci 2015;3:1917-21.
  • 6 Goyal S, Singh UR, Rusia U. Comparative evaluation of bone marrow aspirate with trephine biopsy in hematological disorders and determination of optimum trephine length in lymphoma infiltration. Mediterr J Hematol Infect Dis 2014;6:e2014002.
  • 7 Humphries JE. Dry tap bone marrow aspiration: Clinical significance. Am J Hematol 1990;35:247-50.
  • 8 Sabharwal BD, Malhotra V, Aruna S, Grewal R. Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections. J Postgrad Med 1990;36:194-8.
  • 9 Nanda A, Basu S, Marwaha N. Bone marrow trephine biopsy as an adjunct to bone marrow aspiration. J Assoc Physicians India 2002;50:893-5.
  • 10 Varma N, Dash S, Sarode R, Marwaha N. Relative efficacy of bone marrow trephine biopsy sections as compared to trephine imprints and aspiration smears in routine haematological practice. Indian J Pathol Microbiol 1993;36:215-26.
  • 11 Khan TA, Khan IA, Mahmood K. Diagnostic role of bone marrow aspiration and trephine biopsy in haematological practice. J Postgrad Med Inst 2014;28:217-21.
  • 12 Sah SP, Matutes E, Wotherspoon AC, Morilla R, Catovsky D. A comparison of flow cytometry, bone marrow biopsy, and bone marrow aspirates in the detection of lymphoid infiltration in B cell disorders. J Clin Pathol 2003;56:129-32.
  • 13 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. J Indian Acad Clin Med 2013;14:133-5.
  • 14 Shastry SM, Kolte SS. Spectrum of hematological disorders observed in one-hundred and ten consecutive bone marrow aspirations and biopsies. Med J DY Patil Univ 2015;5:118-21.
  • 15 Younus U, Saba K, Aijaz J, Bukhari MH, Naeem S. Significance of bone marrow histology in the diagnosis of acute myeloid leukemia. Ann King Edward Med Univ 2011;17:5-8.
  • 16 Ghodasara J, Gonsai RN. Comparative evaluation of simultaneous bone marrow aspiration and bone marrow trephine biopsy – A tertiary care hospital based cross-sectional study. Int J Sci Res 2014;10:2058-61.
  • 17 Stifter S, Babarovic E, Valkovic T, Seili-Bekafigo I, Stemberger C, Nacinovic A, et al. Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma. Diagn Pathol 2010;5:30.
  • 18 Bedu-Addo G, Ampem Amoako Y, Bates I. The role of bone marrow aspirate and trephine samples in haematological diagnoses in patients referred to a teaching hospital in Ghana. Ghana Med J 2013;47:74-8.
  • 19 Musolino A, Guazzi A, Nizzoli R, Panebianco M, Mancini C, Ardizzoni A. Accuracy and relative value of bone marrow aspiration in the detection of lymphoid infiltration in non-Hodgkin lymphoma. Tumori 2010;96:24-7.
  • 20 Bearden JD, Ratkin GA, Coltman CA. Comparison of the diagnostic value of bone marrow biopsy and bone marrow aspiration in neoplastic disease. J Clin Pathol 1974;27:738-40.
  • 21 Moid F, DePalma L. Comparison of relative value of bone marrow aspirates and bone marrow trephine biopsies in the diagnosis of solid tumor metastasis and Hodgkin lymphoma: Institutional experience and literature review. Arch Pathol Lab Med 2005;129:497-501.
  • 22 Jeevan SK, Paul-Tara R, Uppin S, Uppin M. Bone marrow granulomas: A retrospective study of 47 cases (A single center experience). Am J Int Med 2014;2:90-4.
  • 23 Chandra S, Chandra H. Comparison of bone marrow aspirate cytology, touch imprint cytology and trephine biopsy for bone marrow evaluation. Hematol Rep 2011;3:65-8.