Comparative utility of diagnostic bone-marrow components: a 10-year study
C L Barekman1, K P Fair, J D Cotelingam
1Section of Hematology, Brooke Army Medical Center, San Antonio, Texas, USA.
American Journal of Hematology
|September 23, 1997
Summary
Bilateral bone marrow aspirates with biopsies are essential for staging neoplasms. Unilateral aspirates suffice for diagnosing cytopenias or leukemia, optimizing diagnostic hematology procedures.
Area of Science:
- Hematology
- Oncology
- Diagnostic Pathology
Background:
- Bone marrow examinations are crucial for diagnosing various hematological and oncological conditions.
- Component inclusion in bone marrow procedures can differ across institutions.
- Understanding the diagnostic yield of each component is vital for optimizing workflows.
Purpose of the Study:
- To evaluate the diagnostic value of specific components in bone marrow examinations.
- To determine the necessity of different bone marrow examination components based on clinical presentation.
- To inform best practices in diagnostic hematology and oncology procedures.
Main Methods:
- Retrospective review of 4,902 consecutive bone marrow examinations over ten years.
- Analysis of diagnostic yield from aspirate smears, clot sections, biopsy cores, and touch imprints.
- Categorization of cases by clinical presentation: neoplasm staging, cytopenias, and acute leukemia.
Main Results:
- Bilateral aspirates with biopsies are required for neoplasm staging.
- Unilateral aspirate with biopsy is sufficient for cytopenia and leukemia assessment.
- Touch imprints and clot sections provided crucial information in specific scenarios, but were rarely solely diagnostic.
Conclusions:
- Procedure requirements for bone marrow examination should be tailored to clinical indications.
- Optimizing bone marrow examination protocols enhances diagnostic accuracy, quality, and efficiency.
- Findings challenge assumptions in routine diagnostic hematology and oncology.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
432
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
432
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
585
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
585
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
349
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
349
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
371
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
371
01:22Bone Marrow Sampling and Transplants
1.3K
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
1.3K
01:29Appendicitis-II: Diagnostic Studies and Management
586
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
586