Comparative Evaluation of Simultaneous Bone Marrow Aspiration and Bone Marrow Trephine Biopsy - A Tertiary Care Hospital Based Cross-Sectional Study

Background: A bone marrow evaluation encompasses bone marrow aspirate (BMA) and bone marrow biopsy (BMB) along with a review of peripheral smear examination. Aim: To compare the diagnostic utility of simultaneous BMA and BMB and to study the concordance rate between the two. Material and methods: All BMA and BMB that were simultaneously done between January 2012 and June 2014 in a Civil hospital, Ahmedabad were reviewed and analyzed in detail. Results: Seventy three aspiration and biopsy slides were reviewed. The commonest indication was anemia (40 %) followed by pancytopenia (27 %) pyrexia of unknown origin (19 %) ; 4 % aspirates biopsies were inadequate. The overall concordance rate between aspirates and biopsy was found to be 73.9 %. Concordance was highest for acute and chronic leukemias, metastatic deposits, multiple myeloma, megaloblastic anemia, tuberculosis and least for lymphoproliferative disorders, myelofibrosis and marrow hypoplasia. Trephine biopsy was useful for patients with acute leukemias, lymphoproliferative disorders, myelofibrosis, marrow hypoplasia, osteitis fibrosa cystica and metastasis. BMB and BMA could detect tuberculous granulomas in 85.17 % and 57.14 % cases, respectively. However, parasitic infections (malaria) could be diagnosed exclusively in BMA. Conclusions: BMA and BMB are important, useful complementary diagnostic tools giving a higher diagnostic yield when used in conjunction.