title: Floatation of decalcified bone marrow core biopsy - a clue to marrow hypocellularity.
abstract: Background : Examination of bone marrow plays a pivotal role in the practice of haematology. It can be evaluated by three ways - bone marrow aspiration smears (BMA), bone marrow touch imprints (BMI) and bone marrow biopsy (BMB). BMB sections are considered to be the gold standard for assessing overall marrow cellularity.
  
  
  OBJECTIVE
  To evaluate the correlation, if any, between bone marrow cellularity and floatation pattern of the core biopsy specimen, after proper decalcification.
  
  
  METHODS
  This study was carried out in the Department of Pathology, Institute of Medical Sciences, Varanasi over a period of 26 months.
  
  
  METHODS
  Specimens of BMA, BMI and BMB were collected from 182 cases. The core biopsy specimens were fixed in 10% buffered formalin for 24 hours, and were decalcified in 5% formic acid for 12 hours. The properly decalcified core biopsy samples were then put into adequate-sized container filled with 10% buffered formalin, and floatation pattern was documented.
  
  
  METHODS
  All the observations were evaluated using simple and basic statistical tools, i.e. sensitivity, specificity, positive predictive value. Chi square test was applied for obtaining statistical correlation i.e. p-value.
  
  
  RESULTS
  Out of 182 core biopsy specimens, 32.4% (n=59) floated, while rests sank. Out of the 59 floating core biopsies, 57 were hypocellular. Seven core biopsies, among 123 specimens that sank, were hypocellular. The sensitivity and specificity of floatation pattern for hypocellular marrow were 89.2% and 99.1%, respectively. A strong correlation (p-value <0.001) between the floatation pattern and bone marrow cellularity was obtained.
  
  
  CONCLUSIONS
  Assessment of floatation pattern of properly decalcified marrow core specimen is reliable for assessing marrow hypocellularity.
authors: Associate Professor, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, India .
authors: Vijai
authors: V
authors: Tilak
authors: Junior Resident, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, India .
authors: Subhajit
authors: S
authors: Das
authors: Associate Professor, Department of Preventive and Social Medicine, Institute of Medical Sciences, Banaras Hindu University , Varanasi, India .
authors: Gyan Prakash
authors: GP
authors: Singh
keywords: Bone marrow aspiration (BMA); Bone marrow biopsy (BMB); Bone marrow imprint (BMI); Floatation pattern
references: J Clin Pathol. 2001 Sep;54(9):657-63
references: 11533068
references: J Clin Pathol. 2001 Oct;54(10):737-42
references: 11577117
references: Hematol Rep. 2011 Oct 19;3(3):e22
references: 22593814