[Clinical diagnosis of aplastic anemia]

A study on the clinical diagnosis of aplastic anemia (AA) was carried out by using 5 different laboratory techniques including bone marrow aspiration and smear. Diagnosis of AA was established in 238 patients. Results with different methods were listed below: (1) Typical picture of AA was found in bone marrow smear of 196 patients. The positive rate was 82.4%. (2) Evaluation of marrow speckles might raise the positive rate to 89.9%. (3) Diagnosis of AA in 103 out of 110 patients was confirmed with bone marrow biopsy. The positive rate was 93.6%. (4) Typical 3-dimensional marrow tissue structure of AA was found in 68 out of 72 patients under scanning electron microscope, with a positive rate of 94.4%. (5) Total body bone marrow gamma-scintigraphy was performed in 56 patients; diagnosis of AA was reconfirmed in 54 patients with a positive rate of 96.4%. (6) 4 or 5 diagnostic techniques were used simultaneously in 30 patients with a positive diagnostic rate of 100%. The methodology of different techniques of bone marrow examination, the typical picture of AA and the causes of missing diagnosis were discussed with certain recommendations on each technique.