Comparison of bone marrow aspiration cytology with bone marrow trephine biopsy histopathology: An observational study

Bone marrow examination is a useful investigative tool for the diagnosis of many hematological and nonhematological disorders. Bone marrow aspiration (BMA) provides information about the numerical and cytological features of marrow cells, whereas bone marrow trephine biopsies (BMB) provide excellent appreciation of spatial relationships between cells and of overall bone marrow structure. We conducted this study with the objective of comparing the accuracy of BMA with BMB in the diagnosis of various hematological disorders.

Both BMA and BMB were performed on a total of 130 cases and a comparative evaluation was performed in 100 cases to see the complementary role of both the procedures. However, 30 cases were excluded due to inadequate BMA, BMB, or both. Immunohistochemistry (IHC) was employed whenever required.

In our study of 100 cases, 87% of cases were confirmed on bone marrow biopsy and in remaining 13% of cases final diagnosis was achieved with the help of other ancillary investigations. These cases were excluded for calculation of concordance rate between BMA and BMB. The concordance and disconcordance rate between BMA and BMB was 72.4% and 27.6%, respectively.

BMA cytology and trephine biopsy histopathology complement each other and the superiority of one method over the other depended on the underlying disorder. Furthermore, application of ancillary techniques such as flow cytometery and IHC proved to be an additional advantage in further typing of various diseases.