Comparative evaluation of bone marrow aspirate particle smears, biopsy imprints, and biopsy sections

Abstract

Bone marrow aspirate particle smears, biopsy imprints, and biopsy sections were compared to determine the accuracy of the three samples in assessing for overall cellularity, differential cell count, megakaryocyte density, iron stores, and tumor infiltration. Aspirate particle smears and biopsy imprints were stained by Wright-Giemsa method. Aspirate particle smears were also stained with Prussian-blue. Biopsy sections were 1 1/2-2 micron thick and were prepared from non-decalcified plastic embedded samples and stained with combined Prussian-blue-hematoxylin-eosin, and Giemsa. One hundred-eight sets of specimens from 99 patients were examined. In 20 cases, chi-square analysis showed a comparable degree of cellularity (p less than 0.001) and megakaryocyte density (p less than 0.001) among the three preparations. Differential count comparison by regression analysis indicated that mean percentages of neutrophilic cells in the proliferation compartment were comparable in the three groups (p less than 0.01). A better correlation was obtained among the three groups in the percent neutrophilic cells in the maturation-storage compartment, normoblasts, eosinophils, and plasma cells (p less than 0.001). Lymphocytes in the aspirate smears correlated with the biopsy imprints (p less than 0.01) but not with the biopsy sections (p greater than 0.05). Monocytes did not correlate in any of the groups (p greater than 0.05). In 47 cases, chi-square analysis of iron stores in the aspirate particle smears correlated well with those in the biopsy sections (p less than 0.001). Fifty-two marrows that were done for staging nonhematological malignancies revealed malignant cells in 21 cases, biopsy sections were positive in all, biopsy imprints were positive in 19 (90%), and aspirate particle smears were positive in 7 (33%). Thirty-six marrows done for staging non-Hodgkin's lymphoma showed malignant cells in 13 cases. Twelve (92%) biopsy sections, three (23%) biopsy imprints, and nine (69%) aspirate particle smears contained lymphoma cells. In conclusion, a satisfactory evaluation of marrow samples for diagnostic studies can be achieved by examination of biopsy sections along with aspirate particle smears or biopsy imprints. Any of the three marrow preparations alone is not sufficient for accurate diagnosis in all cases. The biopsy imprint is an accurate modality for identifying nonhematological tumor metastasis in the bone marrow.

Comparative Evaluation of Simultaneous Bone Marrow Aspiration and Bone Marrow Biopsy: An Institutional Experience

“…Many studies done previously showed that BMB was a better procedure for detecting metastatic tumour. [7][8][9], Only 50% cases showed a positive correlation in our study, which is in agreement with studies by Atac et al [10] where he studied 39 cases and each positive BMB was also positive by BMA. In our study the metastasis were mostly adenocarcinomas 3/6 (primary from gastric carcinoma), 1/6 small cell carcinoma where the primary was unidentified, 2/6 cases of poorly differentiated carcinoma.…”

“…Granulomatous change may be specific or non specific. [8,14] Though AFB stain was not positive in all the cases, the previous clinical history, presentation and other investigations helped us to clinch the diagnosis of a tuberculous granuloma. BMB is a better procedure for detecting granulomas in the marrow.…”

Plasmodium coatneyi in Rhesus Macaques Replicates the Multisystemic Dysfunction of Severe Malaria in Humans

“…Biopsy imprints were made by gently touching the core on slides. The cores were then fixed in 10% formalin (23) and decalcified in RDO Gold (Apex Engineering Products Corp., Aurora, IL). The specimens were embedded in paraffin and cut at 6 m.…”

A Relevance Study of Bone Marrow Aspiration and Bone Marrow Biopsy in Haematological and Non Haematological Disorders

“…It may also play an important role in the assessment of patient with pyrexia of unknown origin (PUO) as well as in the diagnosis of various storage and infiltrative disorders. (5) Bone marrow examination usually involves two separate but interrelated specimen i.e. bone marrow aspiration and needle biopsy of bone and associated marrow.…”