Diagnostic Utility of Bone Marrow Aspiration and Biopsy in Various Hematological Disorders: A Study of 3 Years

Abstract

Background: Bone marrow is involved in variety of hematological and non-hematological disorders. The hematological disorders include acute leukemia, myeloproliferative neoplasm (MPN), hemato-lymphoid neoplasm, nutritional deficiency diseases. On the other hand non-hematological disorders include infectious diseases infiltrating the bone marrow such as tuberculosis, parasitic infections and metastatic deposits

Aim:The aim of study is the diagnostic utility of bone marrow aspiration and biopsy findings in various hematological  disorders

Study Design: This is retrospective study. The findings of bone marrow aspiration and biopsy is correlated in various hematological disorders after retrieving the data from record available in pathology department.

Material and Methods:This was a 3 year retrospective study done in the department of pathology, UPUMS, Saifai, Etawah from Jan 2023 to December 2025. A total of 39 cases presented with clinical haematological disorders. All the smears and sections were reviewed for morphological details and findings on peripheral blood,aspirate and biopsy and compared to each other. A detailed history, clinical findings, routine relevant laboratory investigations and radiological findings were carried out in each case

Results:The most common diagnosis based on BMA cytology was erythroid hyperplasia (normoblastic/micronormoblastic) seen in 9 cases (23.1%), followed by erythroid hyperplasia with megaloblastoid change in 7 cases (17.9%) (Fig 3 a,b) and hypocellular marrow in 5 cases (12.8%)(Fig 4). Other findings included hemodiluted marrow (10.3%), CML (7.7%), myelodysplastic syndrome and ITP (5.1% each), and a few rare entities like ALL, pure red cell aplasia, idiopathic eosinophilia, and inflammatory pathology (2.6% each). In 4 cases (10.3%), aspirate was inadequate for opinion.Concordant diagnosis was observed in 17 cases (48.6%), including conditions like erythroid hyperplasia with megaloblastoid change, marrow hypoplasia, and CML

Conclusion: The study demonstrates a high diagnostic yield of bone marrow examination in evaluating hematological disorders. While BMA is effective and easier, it may be insufficient in certain neoplastic or hypo-plastic disorders. BMB significantly enhances diagnostic accuracy, especially in cases of inadequate aspirate or marrow failure, which is supported by multiple referenced studies