Bone marrow trephine in some hematological and non-hematological disorders

الملخص EN

Objective : to evaluate the frequency, age distribution and document the histological pattern of various hematological disorders reported in bone marrow biopsy.

Methods : A retro and prospective study carried out from 2000 to 2007 at pathology laboratory of Irbil Razkary Hospital.

A total number of 117 cases were investigated.

The biopsy was taken from posterior superior iliac spine by the clinician.

A length of 0.5 to 2 cm of marrow element was obtained, put overnight in 10 % formalin for fixation, followed by decalcification in 5 % nitric acid.

Then processed in usual manner.

Sections were examined by 2 pathologists independently.

Results : the mean age of patients was 46.16 years ranging from 2 years to 76 years.

The male to female ratio was 1.49 : 1.

The commonest presenting clinical features of patients underwent bone marrow biopsy were pallor (91.4 %), followed by body weakness (59.0 %).

The most frequent histological diagnoses in order of frequency were unremarkable bone marrow (28.20 %), lymphoma 11.1 %, acute leukemia, chronic myeloproliferative disorders (9.40 %), chronic leukemia, (5.12 %), multiple myeloma (3.42 %), metastatic tumor (2.56 %), myelodysplastic syndrome and megaloblastic anemia equally reported (1.71 %), pure red cell aplasia and granulomatous inflammation were present in (0.85 %).

Acute leukemia was encountered mostly in 1st and 2nd decades of life.

Lymphoma, chronic leukemia, chronic myeloproliferative disorders occur in 4th and 5th decades.

Myelodysplastic syndrome presented in older age group 5th and 6th decades.

Multiple myeloma and metastases were seen in 6th and 7th decades of life.

Other disorders were randomly distributed.

Conclusion : bone marrow trephine biopsy is an invasive procedure with few known complications, but is a valuable diagnostic tool in the diagnosis, staging, management and follow up of various conditions both neoplastic and non-neoplastic.

High percentage of cases in our study showed normal marrow finding, this may reflect overindication of marrow biopsy, such finding urge for more clinicopathological coordination and data analysis.