Comparison of Bone Marrow Aspiration Cytology, Touch Imprint Cytology and Bone Marrow Biopsy for Bone Marrow Evaluation at a Tertiary Health Care Institute

Abstract

Introduction: Bone marrow examination is an important investigation in haematology which involves Bone Marrow Aspiration (BMA), Bone Marrow Imprint (BMI) and Bone Marrow Biopsy (BMB). Aim: Correlation of findings of bone marrow aspiration and imprint smears with biopsy in hematological disorders. Materials and Methods: It was a prospective study to correlate bone marrow examination findings by BMA, BMI and BMB of 111 patients in which bone marrow biopsy was done and correlated with aspirate and imprint smears. For aspiration Salah's needle and for biopsy Jamshidi needle were used. Correlation of hematological and histopathological findings was done. Results: Megaloblastic anaemia was the commonest diagnosis followed by acute leukemia, nutritional anaemia, chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome, and essential thrombocythemia. In case of dry aspirate or diluted marrow biopsy was useful to diagnose aplastic anemia, and secondary myelofibrosis associated with acute and chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome and myelomonocytic leukemia. Aspirate and imprint smears were better for cellular morphology. Conclusion: Aspiration and imprint smears give better morphological details/cytologic diagnosis. In dry tap or diluted marrow, biopsy was more helpful in identifying architectural pattern, cellularity and fibrosis whereas imprint smears were more helpful for cellular morphology. BMA, BMI and BMB are complimentary to each other.Introduction: Bone marrow examination is an important investigation in haematology which involves Bone Marrow Aspiration (BMA), Bone Marrow Imprint (BMI) and Bone Marrow Biopsy (BMB). Aim: Correlation of findings of bone marrow aspiration and imprint smears with biopsy in hematological disorders. Materials and Methods: It was a prospective study to correlate bone marrow examination findings by BMA, BMI and BMB of 111 patients in which bone marrow biopsy was done and correlated with aspirate and imprint smears. For aspiration Salah's needle and for biopsy Jamshidi needle were used. Correlation of hematological and histopathological findings was done. Results: Megaloblastic anaemia was the commonest diagnosis followed by acute leukemia, nutritional anaemia, chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome, and essential thrombocythemia. In case of dry aspirate or diluted marrow biopsy was useful to diagnose aplastic anemia, and secondary myelofibrosis associated with acute and chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome and myelomonocytic leukemia. Aspirate and imprint smears were better for cellular morphology. Conclusion: Aspiration and imprint smears give better morphological details/cytologic diagnosis. In dry tap or diluted marrow, biopsy was more helpful in identifying architectural pattern, cellularity and fibrosis whereas imprint smears were more helpful for cellular morphology. BMA, BMI and BMB are complimentary to each other.