Bone marrow biopsy diagnostic yield in internal medicine
Jean-Philippe Martellosio1, Mathieu Puyade1, Céline Debiais2
1Service de Médecine Interne, Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Poitiers , Poitiers, France.
Postgraduate Medicine
|October 12, 2020
Summary
Bone marrow biopsy (BMB) in internal medicine effectively diagnoses conditions like cytopenias and monoclonal gammopathies. Combining BMB with bone marrow aspiration (BMA) and immunohistochemistry (IHC) analysis improves diagnostic yield.
Area of Science:
- Internal Medicine
- Hematology
- Diagnostic Procedures
Background:
- Bone marrow biopsy (BMB) is understudied in internal medicine beyond fever/inflammation of unknown origin.
- Limited data exists on BMB diagnostic yield across various internal medicine indications.
Purpose of the Study:
- To evaluate the diagnostic yield of BMB in internal medicine based on primary indications.
- To analyze patient characteristics influencing BMB utility.
- To assess BMB quality and the added value of bone marrow aspiration (BMA).
Main Methods:
- Retrospective analysis of 468 BMBs performed between 2000-2015 at Poitiers University Hospital.
- Data collection included patient demographics, BMB indications, quality metrics, and diagnostic outcomes.
- Diagnostic yield defined as the proportion of BMBs leading to accurate final diagnoses.
Main Results:
- Overall BMB diagnostic yield was 32.7%, with lymphoma as the most frequent finding (31%).
- Cytopenias showed the highest diagnostic yield (49.1%), while fever of unknown origin yielded only 5.6%.
- Anemia, neutropenia, immature cells, monoclonal gammopathy, BMB quality, and IHC analysis correlated with diagnostic yield. Concomitant BMA improved yield by 5.5%.
Conclusions:
- Cytopenias, blood cythemias, and monoclonal gammopathies are key indications for high BMB diagnostic yield.
- Systematic use of concomitant BMA and IHC analysis is recommended to enhance BMB utility in internal medicine.
