Diagnostic role of bone marrow aspiration and trephine biopsy in haematological practice

Abstract

Objective: To determine the usefulness of bone marrow aspiration andtrephine biopsy in evaluation of the bone marrow in routine haematologicalpractice.Methodology: This study included 443 cases of bone marrow examination,referred to Pathology Department, Lady Reading Hospital Peshawar duringthe period extending from January 2012 till July 2013. All the bone marrowsmears and bone biopsy sections were examined in detail. The diagnosis andfindings on aspirate and biopsy were evaluated and compared with eachother.Results: In 73.8% of the cases the bone marrow aspiration and trephine biopsyshowed same diagnosis i.e., bone marrow aspiration alone was sufficientfor diagnosis in these cases. In the remaining 116 (26.2%) cases trephinebiopsy sections or touch imprints were found to be necessary in for makingfinal diagnosis. These cases were those of the hypoplastic / aplastic marrows,Myelofibrosis, lymphomatous infiltration and chronic granulomatousinflammation.Conclusion: The study results suggest that both the aspirate and trephinebiopsy complement each other. Nutritional anaemias, Haematological Malignanciesand Immune Thrombocytopenia can be readily diagnosed by bonemarrow aspiration alone. Trephine biopsy is necessary for diagnosing GranulomatousInflammation and Hypoplastic/Aplastic Anaemia. Also trephinebiopsy is required to diagnose Myelofibrosis and Lymphomatous infiltration.