Comparative Study of Bone Marrow Aspirate and Bone Marrow Trephine Biopsy Findings in Lymphomas
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 1
Abstract
Background and Objective: Bone marrow biopsy is an integral part of staging work-up and prognostication for Hodgkin and non-Hodgkin lymphoma (NHL).Objective of this study is to study and compare the diagnostic findings of aspirates and trephine biopsies in lymphomas. Methods: A prospective study was conducted on sixty two cases of Bone marrow aspirates and trephine biopsies from biopsy proven lymphomas (Hodgkins and Non Hodgkins Lymphoma) for the period of eighteen months from February 2016 to August 2017. Bone marrow biopsies were taken with Jamshidi needle. Trephines were fixed in 10% buffered formalin for 24 hours and then placed in a decalcifying medium (EDTA Tris buffer) for 2 days at room temperature. The serial sections were stained by hematoxylin and eosin and reticulin stains. The bone marrow aspirates and peripheral smears were stained using Leishman stain. Results and Discussion: The study included 6 cases of Hodgkins lymphoma and 56 cases of Non Hodgkin lymphomas. Median age of presentation was 55.2 years. Male: female ratio of 3.4: 1 was observed. A total of 22 cases (35.5%) showed lymphoma infiltrating the bone marrow. The most common pattern of involvement in the study is diffuse pattern (31.8%), followed by mixed pattern (22.7%),focal pattern (18.2%), paratrabecular pattern(9%), interstitial pattern(9%) and nodular pattern of involvement(9%).10 out of 22 bone marrow positive cases showed fibrosis in the trephine biopsy(45%). The highest incidence of marrow involvement was noted in CLL/SLL, hairy cell leukemia (100%), followed by DLBCL(45%) and follicular lymphoma(43%).Atypical lymphoid cells were seen in the bone marrow aspirate in 11 out of 22 cases (50%) that showed marrow involvement in trephine biopsy. 9 out of 62 cases (15%) showed circulating tumour cells in the peripheral blood. Conclusion: Lymphomas in the bone marrow trephine have characteristic infiltration patterns specific to different subtypes of lymphomas. Additional finding like fibrosis is frequent in bone marrow with lymphoma infiltration. The bone marrow aspirate helps in better appreciation of atypical lymphoid cells. Patient with lymphoma should undergo Bone marrow trephine biopsy because of its higher sensitivity compared to Bone marrow aspirate.
Authors and Affiliations
Dr Ranjani M
Keywords
Related Articles
- EP ID EP501972
- DOI -
- Views 52
- Downloads 0
Laparascopic Evaluation and Management of Benign Adnexal Masses
Introduction: Benign adnexal masses can be effectively managed by laparoscopy. Laparoscopy provides the advantage of diagnosis and therapy at the same time. The risk of ovarian malignancy in women undergoing laparoscopy...
Distant Metastases in Head Neck Cancer: An Impact of Reconstruction Modality
Background: With an estimated yearly global burden of 550,000 incident cases and 300,000 deaths Head neck squamous carcinoma is the sixth most common malignancy reported worldwide, and the eighth most common cause of can...
To Correlate the Blood Sugar Level with Age in Diabetic Patients
Diabetes mellitus is a group of disease characterized by high blood glucose concentration in the blood and alteration in carbohydrate, protein and fat metabolism. People are greater risk of diabetes due to improper dieta...
A Case of Male SLE with unusual presentation
Abstract
Gestational Trophoblastic Neoplasia, A Review
GTD is still an important reproductive health problem worldwide. The problem is that much information of GTD has come from less developed countries, where proper diagnostic tools and up to date treatment cannot be employ...