Bone marrow trephine in some hematologicaland non-hematological disorders

Abstract

Objective: To evaluate the frequency, age distribution and document the histological pattern of various hematological disorders reported in bone marrow biopsy. Methods: A retro and prospective study carried out from 2000 to 2007 at pathology laboratory of Irbil Razkary Hospital. A total number of 117 cases were investigated. The biopsy was taken from posterior superior iliac spine by the clinician. A length of 0.5 to 2 cm of marrow element was obtained, put overnight in 10% formalin for fixation, followed by decalcification in 5% nitric acid. Then processed in usual manner. Sections were examined by 2 pathologists independently. Results: the mean age of patients was 46.16 years ranging from 2 years to 76 years. The male to female ratio was 1.49:1. The commonest presenting clinical features of patients underwent bone marrow biopsy were pallor (91.4%), followed by body weakness (59.0%). The most frequent histological diagnoses in order of frequency were unremarkable bone marrow (28.20%), lymphoma (11.1%), acute leukemia, chronic myeloproliferative disorders (9.40%), chronic leukemia, (5.12%), multiple myeloma (3.42%), metastatic tumor (2.56%), myelodysplastic syndrome and megaloblastic anemia equally reported (1.71%), pure red cell aplasia and granulomatous inflammation were present in (0.85%).Acute leukemia was encountered mostly in 1 st and 2 nd decades of life. Lymphoma, chronic leukemia, chronic myeloproliferative disorders occur in 4 th and 5 th decades. Myelodysplastic syndrome presented in older age group 5 th and 6 th decades. Multiple myeloma and metastases were seen in 6 th and 7 th decades of life. Other disorders were randomly distributed. Conclusion: Bone marrow trephine biopsy is an invasive procedure with few known complications, but is a valuable diagnostic tool in the diagnosis, staging, management and follow up of various conditions both neoplastic and non-neoplastic. High percentage of cases in our study showed normal marrow finding, this may reflect overindication of marrow biopsy, such finding urge for more clinicopathological coordination and data analysis.