Correlation of Bone Marrow Aspiration, Trephine Biopsy, and Imprint Cytology in Pancytopenia/ Bicytopenia Cases in Resource-Limited Area
Context: Bone marrow aspiration is a simple method to study hematopoietic disorders whereas trephine biopsy is of greater
value in assessing large piece of marrow. At the same time, imprint is helpful in getting morphological details of individual cell.
Aims: The aim of the present study was to correlate the findings of bone marrow aspirate, bone marrow biopsy (BMB), and
touch imprints in the diagnosis of pancytopenia/bicytopenia.
Settings and Design: This was a cross-sectional study.
Subjects and Methods: This 2-year cross-sectional study of 50 cases from year 2017 to 2019 is conducted in the Department
of Pathology in GMC, Haldwani. The clinical features of pancytopenia/bicytopenia were noted. Bone marrow aspiration (BMA)
along with bone marrow imprint (BMI) was evaluated and BMB was performed in all cases. BMA and imprint smears were stained
with Leishman stain and biopsy section was stained with H.E., PAS, and reticulin stain. Findings were studied and analyzed.
Statistical Analysis Used: All the data were compiled and entered into MS Excel. Statistical analysis was performed using
Results: In all 50 cases, definite diagnosis was made on BMB and strong positive correlation was seen between BMA, BMI,
and BMB (P < 0.00001). Furthermore, 100% correlation was seen in combined nutritional anemia, immune thrombocytopenic
purpura, and metastasis; whereas 82.6% correlation was seen in megaloblastic anemia, 55.6% in reactive marrow, and 50%
in acute leukemia.
Conclusions: The present study concludes that BMA and BMI give good cytomorphological details and take lesser time in
reporting as compared to BMB. BMB whereas is useful for assessment of cellularity, topography, and fibrosis. BMA alone is
usually sufficient to diagnose nutritional anemia, metastasis, and immune thrombocytopenia whereas trephine biopsy is the
sole diagnostic tool in myelofibrosis, granulomatous disease, and aplastic anemia.
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