Bone Marrow Aspiration Findings in Kala-Azar

Daneshbod, Yahya; Dehghani, Seyed Javad; Daneshbod, Khosrow

doi:10.1159/000324961

Cited by 20 publications

(25 citation statements)

References 13 publications

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“…However, in view of presence of frequent hemophgaocytosis, fever, and splenomegaly in majority of the cases, further studies are required to identify the syndrome of VL associated HLH in an endemic country like India. Similar to the study by Daneshbod et al .,[32] the present study showed presence of intracellular and extracellular LD bodies in various aggregates - flower such as - ball-like, platelet-like clusters and within free cytoplasmic bodies; however, no statistical significant association of these arrangements with either APD or HPS was observed. In addition to the presence of LD bodies within histiocytes, they were also noted within megakaryocytes, myelocytes, and plasma cells.…”

Section: Discussionsupporting

confidence: 90%

Spectrum of clinicohematological profile and its correlation with average parasite density in visceral leishmaniasis

et al. 2018

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Background:Leishmaniasis is the prevalent in tropical and subtropical regions of the world. Demonstration of Leishman-Donovan (LD) bodies in the bone marrow aspirates (BMA) is vital to diagnosis of visceral leishmaniasis (VL). In the present study, we studied the clinicohematological parameters encountered in VL and correlated them with parasite load on BMA.Methods:Retrospective analysis over 3 years was done; clinical details, biochemical profile, complete hemogram with peripheral smear findings, and BMA smears were reviewed and average parasite density (APD) calculated in each case. Multivariate analysis and tests of significance were applied.Results:The study included 28 patients. Splenomegaly showed a positive trend with APD. rK39 antigen detection test was 100% positive in select cases. A strong negative correlation was observed between albumin to globulin ratio and grade of APD. BMA revealed hemophagocytosis (HPS) in 78.57% cases and it had a significant strong correlation with APD (P = 0.014). A significant correlation was also observed between APD and bone marrow plasma cell percentage (P = 0.01). LD bodies were noted in unusual locations such as within myelocytes (14.2%), plasma cells (7.1%), and megakaryocytes (10.7%).Conclusion:HPS and bone marrow plasmacytosis were two statistically significant findings, which showed positive correlation with parasite load. The presence of these two findings should prompt hematopathologists for more focused search of hemoparasites in BMA to arrive at a definitive diagnosis. This will avoid unnecessary workups and improve the prognosis. To the best of our knowledge, a statistical correlation between APD and clinicohematological parameters has never been previously studied.

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Section: Discussionsupporting

confidence: 90%

Spectrum of clinicohematological profile and its correlation with average parasite density in visceral leishmaniasis

et al. 2018

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“…The Geimsa stained slides of bone marrow aspirates and hematoxylin and Eosin stained biopsy slides were reviewed and discussed in detail by three competent hemato-pathologists. All the findings were tabulated, discussed and deliberated upon and then graded as common, uncommon and atypical findings based on a previous study by Yahya Daneshbod et al1 The common findings included-Peripheral blood pancytopenia, monocytosis and nRBC’s, Bone marrow aspirate-Average Parasite Density, plasmacytosis, reversed M:E ratio with dyserythropoiesis, histiocytes and LD body distribution and on Trephine biopsies-the presence of granulomas. The uncommon findings included-presence of LD bodies in cells other than histiocytes, plasma cells with abnormal inclusions, presence of blasts/hematogones and the grade of hemophagocytosis.…”

Section: Methodsmentioning

confidence: 99%

A Case Series Highlighting the Relative Frequency of Common, Uncommon and Atypical/Unusual Hematological Findings on Bone Marrow Examination in Cases of Visceral Leishmaniasis

Bhatia¹,

Haldar²,

Varma³

et al. 2011

Mediterr J Hematol Infect Dis

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Introduction:Bone marrow aspiration and biopsy still remains as one of the vital tests for confirmation of diagnosis of visceral Leishmaniasis. The aim of the present study is to assess the relative frequency of common, uncommon and atypical hematological findings in cases of Visceral Leishmaniasis.Materials & Methods:A total of 16 cases of Leishmaniasis diagnosed on Bone marrow examination over a period of two years (2008–2010), were retrieved from the archives and the peripheral blood smear, bone marrow aspiration smears and trephine biopsies were examined for the common, uncommon and atypical features as described in the literature.Results:Out of the total of 16 cases, 10 were pediatric and 6 adult cases. The common findings like pancytopenia, peripheral blood monocytosis, increased histiocytes on aspirate smears and granulomas on biopsies were noted in 12/16 (75%), 9/16 (56.25%), 13/16 (81.2%) and 11/16 (69%) cases respectively. Amongst the uncommon findings, hemophagocytosis was noted in 12/16 (75%) cases, plasma cells with inclusions in 6/16 (37.5%) and LD bodies in cells other than histiocytes in 4/16 (25%) cases. The atypical findings included organism aggregates noted in 9/16 (56%) cases, Pelger-Heut cells seen in 4/16 (25%) cases and increased focal vascularity on biopsies in 10/16 (62.5%) cases. The average parasite density (APD) on smears was 3+ and the range of positivity was 1+ to 5+.Conclusion:The knowledge of these morphological clues can assist us in searching for LD bodies and correctly diagnosing the condition without excessive dependence on unnecessary and sophisticated tests.

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“…However, in a smear exam, the presence of other microorganisms and/or artifacts may occur and this can lead to misdiagnosis [13]. Considering that direct examination is often subjective, it is important to conduct regular qualification and training programs for professionals who perform this activity.…”

Section: Discussionmentioning

confidence: 99%

Tegumentary Leishmaniasis: A Diagnostic Approach Considering Aspects of the Cytological Examination

Mello

Morais²,

Schubach³

et al. 2014

Acta Cytologica

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Objective: To elaborate figures that highlight the microscopic appearance of amastigote forms of the genus Leishmania and other structures subject to confusion during the routine of the direct examination of tegumentary leishmaniasis (TL). Study Design: We reviewed imprint and scraping slides previously prepared from patients with a definite diagnosis. Smear examinations were performed with an immersion objective (×1,000) selecting structures of interest for photodocumentation and elaboration of the illustrations. Results: We elaborated two 13 × 17 cm figures containing photomicrographs of amastigote forms with typical and atypical morphology of Leishmania parasites and other microorganisms, mainly fungi in the yeast-like phase and bacteria which could be confused with amastigote forms during the direct examination. Conclusions: The production of material like we show here is important and should be encouraged because of the need for constant training of professionals working in the area of TL diagnosis.

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Bone Marrow Aspiration Findings in Kala-Azar

Cited by 20 publications

References 13 publications

Spectrum of clinicohematological profile and its correlation with average parasite density in visceral leishmaniasis

Spectrum of clinicohematological profile and its correlation with average parasite density in visceral leishmaniasis

A Case Series Highlighting the Relative Frequency of Common, Uncommon and Atypical/Unusual Hematological Findings on Bone Marrow Examination in Cases of Visceral Leishmaniasis

Tegumentary Leishmaniasis: A Diagnostic Approach Considering Aspects of the Cytological Examination

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