Comparative utility of bone marrow aspiration and trephine biopsy in evaluation of hematological disorders

Abstract

Background: Bone marrow examination is a useful investigative tool to diagnose several hematological and nonhematological disorders. While the aspiration provides excellent cytological detail, the biopsy provides information regarding the spatial relationships of cells, marrow architecture, and valuable information when aspirate is nondiagnostic. We conducted this study to compare the diagnostic usefulness and comparison between aspirate and trephine biopsies in the evaluation of hematological disorders. Aim: The aim was to assess the relative efficacy of bone marrow aspiration and trephine biopsy and the overall diagnostic utility of this procedure in the diagnosis of hematological and nonhematological disorders. Materials and Methods: This is a retrospective study of 6-month duration at a tertiary care hospital in Himachal Pradesh. Patients were aged from 1 to 85 years. A total of 169 cases were studied, in whom bone marrow aspiration and trephine biopsy were performed, with special stains used where required. Results: A specific pathology was found in 89 cases(52.66%), rest being a normal or unsatisfactory study. Trephine biopsy was fundamental in the diagnosis in 69 cases(48.93%). Nearly 21.05% of the aspirates indicating a normal study further revealed a specific pathology on trephine biopsy and 38.88% of the unsatisfactory aspirates revealed definite pathology on biopsy. We noted that 8.87% of cases were diagnosed by trephine biopsy alone, with 89.94% concordance between trephine biopsy and aspiration. Conclusion: Bone marrow aspirate cytology and trephine biopsy are useful adjuncts to each other and should be used to supplement each other in arriving at a definite diagnosis, and they remain as a key diagnostic tool in hematological disorders.