Significance of bone marrow trephine biopsy in the diagnosis of hematological and non-hematological disorders

Abstract

Objective: To evaluate the frequency and document the histological pattern of various haematologic and non –haematologic malignancies and infections, which can be diagnosed by Bone marrow trephine biopsy. Methods: A retrospective, cross sectional study was carried out at Histopathology department of Army Medical College Rawalpindi from January 2000 to December 2004. The bone marrow trephine biopsies were taken with Jamshidi`s - type needle. The tissues were fixed in 10 % formal- saline and then decalcified in 5 % nitric acid. These were processed under standard conditions. Results: A total of 789 cases with age range of 9 years to 75 years were studied during a period of five years. Majority of the cases showed male preponderance (69.83%) as compared to females (30.16%). The most common histological findings in order of frequency were reactive changes (22.43%), unremarkable marrow (16.09%), inadequate biopsy (9.63%), megaloblastic anaemia (7.73%), acute leukaemia (6.21%), erythroid hyperplasia (5.95%). The less common lesions were multiple myeloma (3.92%), lymphoproliferative disorders (3.80%), hypoplastic marrow (3.54%), chronic granulomatous inflammation (2.53%) and myelofibrosis (2.40%). The miscellaneous group (5.70%) comprises rare diseases. Conclusion: Bone marrow trephine biopsy is a valuable diagnostic tool in the diagnosis of various types of infections and hematologic and non–hematologic malignancies. Majority of our patients showed reactive changes followed by acute leukaemia and erythroid hyperplasia. It has also been proved useful in detecting micrometastases when primary is not known with the other available diagnostic modalities.