Utility of bone marrow aspiration and trephine biopsy in various haematological malignancies

Shilpa Thakur; Bharti Thaker; Kailash Singh Thaker; Afsana Anjum

doi:10.18203/2320-6012.ijrms20230693

Authors

Shilpa Thakur Department of Pathology, Government Medical College Jammu, Jammu and Kashmir, India
Bharti Thaker Department of Pathology, Government Medical College Jammu, Jammu and Kashmir, India
Kailash Singh Thaker Department of Surgery, Government Medical College Jammu, Jammu and Kashmir, India
Afsana Anjum Department of Surgery, Government Medical College Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230693

Keywords:

Aspiration, Biopsy, Bone marrow, Concordance

Abstract

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.

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