Affiliation:
1. M
2. M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
Abstract
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.
Publisher
IP Innovative Publication Pvt Ltd
Reference20 articles.
1. N Singhal, N Gupta, Kulhari S, Evaluation of Bone Marrow Examination in Cases of Pancytopenia in Tertiary Health Center in North-West Rajasthan.Int J Contemp Med Res 2019;6(3):1-4
2. B Mohanty, R Singh , Satish P, Changing Trends in Etiology of Pancytopenia-our Experience.Arch Gen Intern Med 2017;1(4):1-6
3. NB Vijaya , PV Ramana , Diagnostic utility of bone marrow aspiration in pancytopenia.IAIM 2018;5(9):1-6
4. Makheja KD, Maheshwari KB, Arain S, Kumar S, Kumari S, Vikash S, The common causes leading to pancytopenia in patients presenting to tertiary care hospital.Pak J Med Sci 2013;29(5):1108-11
5. Evaluation of bone marrow in patients with pancytopenia