Bone marrow trephine biopsy as an adjunct to bone marrow aspiration.
OBJECTIVE
To determine the relative efficacy of bone marrow aspiration as compared to that of trephine biopsy.


METHODS
Bone marrow aspiration and bilateral trephine biopsies were performed in 420 consecutive cases. The diagnosis and findings made on bone marrow aspiration were compared with that made on trephine biopsy in each case.


RESULTS
Aspiration alone was sufficient in making a diagnosis in 372 (88.6%) cases as it correlated well with the diagnosis made on trephine sections. In the remaining 48 (11.4%) cases trephine biopsy was necessary for making a diagnosis due to incomplete information provided by aspiration or its inability to give a correct diagnosis. These cases were mostly hypoplastic/aplastic marrow, myelofibrosis and marrow involvement by metastatic tumour and lymphomatous infiltration. Often a bilateral marrow biopsy picked up the diagnostic lesion.


CONCLUSIONS
The decision to perform a marrow aspiration alone or in combination with marrow biopsy depends on the diagnosis being considered. In nutritional anaemias, most hematologic malignancies and immune thrombocytopenias, marrow aspiration alone is sufficient, but for detection of disorders with focal marrow involvement bilateral marrow biopsies are a must.
Nanda
Annu
A
Department of Haematology and Transfusion Medicine, Government Medical College, Chandigarh.
Basu
Sabita
S
Marwaha
Neelam
N
D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology*; D001855:Bone Marrow Diseases / Q000175:diagnosis*; D006801:Humans