Correlation Between Bone Marrow Aspiration and Bone Marrow Biopsy with Imprint Smears in Hematological Disorders

Abstract

Introduction: Bone marrow examination is an important diagnostic tool and the cornerstone of hematology. It involves the use of Bone marrow aspiration (BMA), Bone marrow imprint (BMI) and Bone marrow biopsy (BMB). Aim: The study was aimed to correlate findings of bone marrow aspiration and imprint smears with biopsy in hematological disorders. Materials and Methods: A retrospective and prospective study was done to correlate bone marrow examination findings by different diagnostic tools. The results were observed and analyzed. 75 consecutive patients in which bone marrow biopsy was done were correlated with aspirate and imprint smears. A single needle technique using Jamshidi needle was used for both aspiration and biopsy. Hematological and histopathological findings were correlated. Statistical analysis was done using SPSS software version 21. Results: Total of 46 cases showed positive concordance between bone marrow aspiration and biopsy. Maximum cases were those of nutritional anemia followed by aplastic anemia, acute leukemia, MDS, chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome, follow-up case of hematological malignancy and essential thrombocythemia. Biopsy was useful in cases of aplastic anemia, acute and chronic leukemia, multiple myeloma, leukemia/lymphoma syndrome and myelomonocytic leukemia with secondary myelofibrosis where aspiration had yielded dry tap /diluted marrow. Morphological details were better appreciated in aspirate and imprint smears. Perl stain was better appreciated in aspirate smears as compared to biopsy sections. Conclusion: BMA and biopsy were complementary modalities. Aspiration and imprint smears provided good morphological details/cytologic diagnosis. Biopsy sections were helpful in cases where aspiration yielded dry tap or diluted marrow and in identifying architectural pattern, cellularity and fibrosis. Imprint smears were mainly useful for studying cellular morphology where aspiration yielded dry tap or diluted marrow.

Keywords

• concordance
• dry tap
• imprint cytology
• perl stain