Sandhya Rani Sahoo
BACKGROUND
Bone Marrow Trephine Biopsy (BMTB) and aspiration is critical for diagnosis, prognostic evaluation and monitoring therapeutic response. BMTB is of greater value in assessing cellularity, degree of fibrosis, marrow architecture and especially when aspiration is dry tap. At the same time, it provides sample for immunohistochemistry.
MATERIALSAND METHODS
It is a single centre observational study conducted from July 2014 to July 2016 in Department of Pathology, S.C.B. Medical College, Cuttack, which included both cell block and touch imprint along with trephine biopsy. Cases selected where lymphoma studied for pattern and extent of infiltration. Aspiration with dry tap and selected cases of myeloproliferative disorders, myelodysplastic syndrome, leukaemia (both acute and chronic), anaemia, multiple myeloma were studied. Jamshidi needle was used for biopsy. Samples obtained were formalin preserved, kept in decalcification solution (Hammersmith protocol) and H and E slides prepared. Special stain-like reticulin and Masson’s trichrome were used for grading of fibrosis. Immunohistochemistry was done on selected cases of lymphoma.
RESULTS
Out of total 100 cases studied, 60 were of haematopoietic and lymphoid neoplasms, 12 anaemia, 20 secondary metastasis, 8 miscellaneous (1 haemophagocytic lymphohistiocytic disease, 1 storage disease, 1 granulomatous and 5 ITP).
CONCLUSION
The study was conducted to establish the advantage of bone marrow biopsy in inadequate and failed aspiration, but both are complementary to each other and together provide a comprehensive evaluation of the bone marrow. Bone marrow fibrosis are well accessed and increased detection of tumour cells in suspected secondary metastasis. Special stains, IHC, cytogenetic study can be done over biopsy block.
