TO STUDY BONE MARROW ASPIRATE AND BONE MARROW BIOPSY IN THOSE HEMATOLOGIC DISORDERS IN WHICH THE PERIPHERAL BLOOD SMEAR EXAMINATION RESULTS ARE INCONCLUSIVE.

Abstract

Background & Method: Present study is done with an aim to study bone marrow aspirate and bone marrow biopsy in those hematologic disorders in which the peripheral blood smear examination results are inconclusive. The selection of cases were based on the clinical examination and peripheral blood picture of patients attending the haematology department in which the findings of peripheral blood smear were unexplained or inconclusive and bone marrow examination was warranted.

Result: A difference in extent of blast cell infiltration between the aspirate and biopsy sections. Extent of blast cell infiltration was higher in biopsy than in the aspirate. Residual erythropoiesis was seen in small islands in biopsy but noticeably absent in the aspirate smears. Distribution pattern of megakarycytes was affected and they were either widely scattered or localized in small clusters, while they were not found in aspirate smear. 12 cases (63.2%) showed early megaloblasts, 05 cases (26.3%) exhibited late normoblasts and 02 cases (10.5%) had macronormoblasts in their bone marrow aspirate. 17 cases (89.5%) showed giant metamyelocytes and 15 cases (78.9%) had dysmegakarypoiesis.

In present study in all cases (100%) megaloblasts were found. Reduced M:E ratio was seen in 94.7% cases. 84.2% cases were hypercellular. In 94.7% cases giant metamyelocytes and in 89.5% cases increased iron stores were noted. Peripheral smear gave only the rough idea of the diagnosis Bone marrow aspirate was the most helpful in making the diagnosis. Morphology of megaloblasts was best appreciated in bone marrow aspirate. Bone marrow biopsy gave better idea of cellularity.

Conclusion: Peripheral smear gave only the rough idea of the diagnosis in cases of Megaloblastic anemia. Bone marrow aspirate was the most helpful in making the diagnosis. Morphology of megaloblasts was best appreciated in bone marrow aspirate. Bone marrow biopsy gave better idea of cellularity. Out of 19 cases 94.7 cases were diagnosed on bone marrow aspirate and in only 5.3 cases bone marrow biopsy had added advantage.

Keywords: bone marrow, aspirate, biopsy & hematologic.