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PubMed1996

Prognostic significance of bone marrow trephine and peripheral blood smears in 55 patients with mantle cell lymphoma.

Bone marrow trephine and peripheral blood smears taken at diagnosis of 55 cases of well-documented mantle cell lymphomas were reviewed in order to analyse the leukaemic involvement in this non-Hodgkin's lymphoma: its incidence, morphological characteristics and prognostic significance. A median survival of 36 months was found. The median age was 61 and the male to female ratio was 4:1. Morphologically 7 cases presented with a mantle zone pattern, all the others had a diffuse pattern. Involvement of the bone marrow was found in 58% and a trend for prolonged survival in patients with a negative trephine was seen. An absolute lymphocytosis above 10,000 mu l was found at diagnosis in 5 cases (10%) and had a statistically significant impact on survival. An additional 5 cases developed frank leukaemia during the course of the disease and died within 1 to 6 months of this evolution, suggesting that marked lymphocytosis is more a terminal event associated with an extremely poor prognosis than a presenting symptom. Finally we identified an additional parameter with statistically prognostic significance, namely, the presence of atypical cells in the peripheral blood even in the absence of an increased lymphocytosis.

Adult↗
PubMed1975

Bilateral trephine bone marrow biopsies in lymphoma and other neoplastic diseases.

We have evaluated the usefulness of bilateral rather than unilateral posterior iliac spine trephine biopsies in searching for lymphoma and other neoplastic diseases in the bone marrow. Two hundred and eighty-two patients with these diseases were studied. Tumor was found on only one side in 22% of patients with non-Hodgkin's malignant lymphoma, in 43% of patients with Hodgkin's disease, and in 36% of patients with other neoplastic processes. Thus, the second biopsy yields an additional 11% to 22% of positive biopsies. We conclude that bilateral trephine bone marrow biopsies should be routinely performed when searching for tumor in the bone marrow.

Biopsy, Needle↗
PubMed1999

Use of image analysis and immunostaining of bone marrow trephine biopsy specimens to quantify residual disease in patients with B-cell chronic lymphocytic leukemia.

Marrow residual disease (RD) in patients with B-cell chronic lymphocytic leukemia (B-CLL) who are in complete remission (CR) after treatment with purine analogues is reported to have a prognostic value, but sample dilution, factors interfering with marrow aspiration, or undetectable immunoglobulin rearrangement can affect the assessment of RD by molecular or immunologic methods. As demonstrated for hairy cell leukemia and follicular lymphoma, bone marrow trephine biopsy specimen immunostaining (BMT/IS) can successfully detect residual malignant cells. The aim of this study was to use BMT/IS and computerized image analysis (CIMA) of bcl-2-positive cells to quantify RD in B-CLL patients in CR, after achievement of CR and more than 1 year later. This methodology was compared with other conventional techniques, i.e., cytologic, flow cytometric, cytogenetic, and molecular analysis. BMT/IS readily detected RD in every trephine biopsy specimen examined, either after CR or at distant follow-up. CIMA allowed an objective quantification of residual B-CLL cells, as evidenced by the correlation with semiquantitative polymerase chain reaction results. Both analyses indicated a progression of RD. This finding was also supported (but inconsistently) by the other techniques. CIMA with an interstitial labeling index, therefore, seems to be a reproducible and sensitive method to detect persistence and progression of RD in patients with B-CLL. This method could apply to other hematologic malignancies infiltrating the bone marrow.

Adult↗
PubMed1999

CD138/syndecan-1: a useful immunohistochemical marker of normal and neoplastic plasma cells on routine trephine bone marrow biopsies.

Detection of abnormal numbers and/or distribution of bone marrow (BM) plasma cells (PCs) on trephine biopsies can be important in the differential diagnosis of multiple myeloma (MM) and other PC disorders. A variety of immunohistochemical markers can potentially improve the specificity and sensitivity of PC detection on routine histological sections obtained from trephine BM biopsies, but most of them are not completely satisfactory. In this study, we investigated whether the antibody CD138/B-B4, which is an optimal marker for PC detection on BM aspirates by flow cytometry, can be used successfully for the identification of PCs also on formalin-fixed, decalcified biopsies. A series of samples including normal BM [12], MM [65], monoclonal gammopathies of undetermined significance [44], and B-cell lymphoma of various types [94], including B-cell precursor lymphoblastic leukemia [9], lymphoplasmacytoid [17], immunoblastic [14], lymphocytic/CLL [23], hairy cell leukemia [4], large B-cell [8], mantle-cell [3], marginal zone [6] and follicular [10] lymphomas, have been investigated for CD138 expression using a sensitive immunohistochemical technique. Within the BM microenvironment, CD138 was characterized by excellent sensitivity and specificity. Virtually all normal and neoplastic PCs expressed clear-cut membrane CD138 immunostaining, whereas all other cell types did not. All cases of MM, including plasmablastic and leukemic cases, showed strong immunoreactivity. Conversely, all B-cell lymphomas, including all cases characterized by secretive features, lymphoplasmacytoid, and immunoblastic lymphomas, were completely negative. These results demonstrate that CD138 is a highly sensitive and specific marker that is useful for the rapid and precise localization of normal and neoplastic PCs on routine BM sections. In addition, because of its clear-cut cell membrane localization, CD138 can be used successfully in double-marker immunostaining reactions to evaluate precisely nuclear prognostic markers such as Ki67 and p53 in MMs.

Biomarkers, Tumor↗
PubMed1999

[Treatment of late thoracolumbar fracture by transpedicular decompression using "PUMC trephine" 26 cases report].

OBJECTIVE: To introduce a new operation to treat late thoracolumbar fracture cases with neurological deficit or with kyphosis. METHODS: 26 cases were treated with "PUMC trephine" (designed by professor Ye Qibin). RESULTS: The kyphosis was (29.7 +/- 14.5) degrees Cobb's angle in pre-operation and (10 +/- 11.8) degrees in post-operation (P < 0.01). The angle of correction was (19.7 +/- +9.9) degrees. The height of the anterior edge of traumatic-vertebra was (16.3 +/- 5.7) mm in pre-operation and (22.2 +/- 6.3) mm in post-operation. The corrected height was (6.5 +/- 3.2) mm. The neurological deficit also got a better recovery in 17 of 19 cases, 12 of 15 cases obtained complete cure of incontinence. 11 of 15 case had sexual function recovery after following up 1-9 years (average 5.2 years) cases. CONCLUSIONS: Using "PUMC trephine" procedure was a new, simple, safety and less-traumatic technique for treatment of late thoracolumbar fracture through posterior approach.

Adult↗
PubMed2003

Morphometric classification of hairy cell leukemia in bone marrow trephine biopsy.

OBJECTIVE: To analyze cytologic and histologic parameters in bone marrow trephine biopsy in an attempt to define heterogeneity of hairy cell leukemia cells. STUDY DESIGN: The study group consisted of 28 trephine biopsies. Immunohistochemistry for CD20 antigen was used. Image processing and measurements were performed with AnalySIS 3.0 image analysis system (Soft Imaging System GmbH, Germany) and custom built programs. For planimetric measurements of nuclei, automatic segmentation was implemented. The measured parameters were: surface area, perimeter, minimum, mean and maximum diameter, and a set of form factors. Relative volumes of bone trabeculae, adipose tissue, hematopoietic tissue and neoplastic infiltrate were assessed by the point counting method. Nuclear volume was measured by the point sampled intercept method. Bone marrow fibrosis was assessed using a curvilinear line test system. RESULTS: Significant variability of cell nuclei was found, and their classification into 3 types was possible. The relative frequency of those types was different in various cases and allowed subdivision of cases into 3 groups that differed in some clinical and histologic manifestations. CONCLUSION: The present study demonstrated the heterogeneity of cell populations of hairy cell leukemia.

Adult↗
PubMed1992

Experience with bone marrow trephine biopsy.

One hundred and ten bone marrow trephine biopsies were studied from January 1987 to July 1989, using Zenker's acetic acid as fixative and routine paraffin embedding. Trephine biopsies were useful in differential diagnosis of cytopenias, especially when bone marrow aspiration was hypocellular or a dry tap, and in staging of lymphomas and multiple myeloma.

Biopsy, Needle↗
PubMedDate not supplied

A review of histology of bone marrow trephine in malignant lymphomas.

BACKGROUND: To investigate the prevalence and pattern of bone marrow involvement and its effects on the peripheral blood counts of malignant lymphoma patients. METHODS: A prospective study of patients with histologically confirmed malignant lymphomas that presented from January 1994 to December, 1999 at the Department of Haematology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife. Patients underwent routine investigations such as packed cell volume (PCV); white blood cell counts (total and differentials), and platelet counts. Bone marrow aspirates and trephine biopsies were carried out on admission. Histological classification was based on the working formulation, while clinical staging was based on the Ann Arbor classification. The data collected was analysed using simple statistical methods and Epi info 6. (World Health Organisation), Geneva, Center for disease control (CDC), Atlanta, USA (1994) statistical software was used for all statistical analysis. RESULTS: Out of the thirty cases (19 males and 11 females) of lymphoma that were studied, twenty-four (80%) were Non Hodgkins lymphoma (NHL) and 6 (20%) were Hodgkins disease (HD). In the NHLs, age range was 18-75 years with a median of 50 years with sixteen males and eight females, male:female ratio 2:1. Twelve of the patients had marrow involvement and were low-grade indolent disease. The most common pattern of marrow involvement in NHL was diffuse type. In HD, the age range was 18-65 years with a median of 45.5 years. There were three females and three males with M:F of 1:1. The most common pattern of marrow involvement was mixed cellularity in four patients, while one patient had lymphocyte predominant and the other lymphocyte depleted. In all cases with marrow involvement there were varying degrees of marrow suppression as reflected by anaemia and thrombocytopaenia, and in one pancytopaenia. CONCLUSION: Bone marrow examination is an important aspect in the diagnosis of patients with malignant lymphoma and there is superiority of trephine biopsy over the aspiration biopsy.

Adolescent↗
PubMed2004

[Clinical application of maxillary sinus augmentation, bone graft and simultaneously placement of implant with trephine bur].

OBJECTIVE: To introduce and evaluate the procedure and the effect of localized management of sinus floor (LMSF), bone graft and simultaneous implant placement with trephine bur in maxillary posterior region. METHODS: 24 patients without enough alveolar bone height received LMSF, bone grafting and implants placement were carried out simultaneously.The autogenous bone were harvested by trephine bur in situ. Patients were followed up after 1 week, 1, 3 and 6 month. RESULTS: There was no implant loose or lost and maxillary antritis. 6 months postoperatively, bone graft reformed to new bone seen in X-ray films, sinus floors were augmented and reached the requirements of dental implants. The implant osseointegrated tightly with new bone which was satisfactory to second-step prosthesis after implant placement of 6 months later. CONCLUSIONS: The method enlarges the indication of dental implants and avoids operation of harvesting autogenous bone in other site. It is simple and valuable to clinical application.

Adult↗
PubMed2004

Unusual presentation of the "syndrome of the trephined".

A 45-year-old lady underwent right fronto-parietal craniotomy and subtotal excision of a parasagittal meningioma. Bone flap was not replaced as it was infiltrated by the tumor. In the postoperative period she developed episodes of altered sensorium associated with worsening of left hemiparesis and a sunken scalp at the site of bone defect. Computed tomography (CT) of brain showed sunken scalp flap in the right fronto-parietal region with compression of the underlying brain. A diagnosis of syndrome of the trephined was considered and her symptoms improved with cranioplasty. Pathophysiology of the syndrome of the trephined is discussed.

Female↗
PubMed2002

Bone marrow trephine biopsy findings in chronic myeloid leukemia.

Sixty patients with chronic myeloid leukemia (CML) underwent bone marrow trephine biopsy at presentation. All the biopsies were decalcified, paraffin-embedded and stained with H&E, Gomori's reticulin and Masson Trichrome. A detailed study of the histology including the morphology and topographic distribution of megakaryocytes was done. 55 patients presented in chronic phase. Of these there were 37 cases (67%) of CML-granulocytic (CML-G) type and 18 cases (33%) of CML-granulocytic megakaryocytic (CML -GM) type. Five cases presented in blast crisis. 73% of CML-G had low-grade fibrosis while 83% of CML-GM had high-grade fibrosis. This was statistically significant. On follow-up 25% of CML-G went into blast crisis while all the CML-GM patients remained stable to date. Bone marrow biopsy is a useful investigation in patients of CML at diagnosis as it provides prognostic information. Evaluation of megakaryopoiesis, grading of fibrosis and localization of blasts are possible on a trephine biopsy.

Biopsy↗
PubMed1991

The value of percutaneous trephine biopsy in the diagnosis of lesions of the vertebral column.

The results obtained in 55 adult patients with sinister lesions of vertebral bodies, who were subjected to percutaneous trephine biopsy, are presented. A positive diagnosis was made on histopathological examination of specimens from 24 patients (44%). In the remaining 31 patients (56%), pathological features were seen in 25, but no specific diagnosis was possible. There were 4 false-negative results. The lack of diagnostic specificity in a large proportion of the patients is explained by the fact that they presented at an advanced stage of disease (probably tuberculosis) when the process of healing had already started. In bony malignant conditions the results were very satisfactory. Percutaneous trephine biopsy is therefore a valuable diagnostic tool for positive diagnosis in a large proportion of patients with osseous lesions and for the exclusion of malignant disease.

Adolescent↗
PubMed1991

[Effect of trephination on the cut-edge of cornea].

Corneal buttons were cut from rabbit and human eyes by anterior trephination and scissor completion or by posterior punching. Light microscope was used to measure the inward bevelling of the corneal cut-edge. With anterior trephination, the apparent width of inward bevelling of rabbit corneal buttons was 0.757 +/- 0.232 mm; with posterior punching, the apparent width of inward bevelling was 0.466 +/- 0.161 mm, and the cut-edge was also smooth. The mechanism of cut-edge bevelling was discussed.

Animals↗
PubMed1988

Corneal endothelial cell loss following trephination.

The amount of endothelial cell loss that occurs to the donor cornea during the trephination process was evaluated in 40 porcine eyes. A vital staining technique (alizarin red S and acid violet 19) was used to quantify the extent of endothelial damage and removal. Two types of corneal punches (Weck and H&I0 were used for trephination. The average amount of endothelial loss from the peripheral cornea was 7.9%, accounting for only a 3% loss of endothelial cells over the total surface area of the corneal button. a comparison of the Weck and H&I corneal punches showed no significant difference (P greater than 0.1) by Student's test for both endothelial cell damage and removal.

Animals↗
PubMed1989

[Trephine biopsy of the bone marrow in patients with hairy cell leukemia].

The bone marrow histological picture was studied in 13 patients with hairy-cell leukemia (HCL) who were followed up at the Hematological Centre in the Latvian SSR. The diagnosis was made or proved in all the cases, among them in 9 patients - on the basis of the proliferation type of leukemia cells in the bone marrow trephine biopsy that is characteristic of HCL. The analysis of the clinical and morphological features of the disease has permitted the authors to distinguish specific types of HCL: 1) splenic and bone-marrow variants predominantly were diagnosed clinically, 2) typical and atypical variants resembling malignant lymphoma or chronic lymphoid leukemia were diagnosed histomorphologically. The authors have recommended trephine biopsy+ for a wider use (as a more informative method as compared to sternal punction) in the diagnosis and differential diagnosis of HCL.

Adult↗
PubMed1989

Cellularity of bone marrow--a comparison of trephine biopsies and aspirate smears.

The estimation of cellularity of bone marrow was done on 212 trephine biopsies and their corresponding aspirate smears by a single observer using the visual scanning method. On applying the statistical test of agreement, it was found that the trephine biopsies and the aspirate smears were equally reliable in assessing marrow cellularity.

Biopsy, Needle↗
PubMed1977

[Express method of histological processing of trephined bone marrow].

A method for histological treatment of the trephined bone marrow is suggested; it makes it possible to simplify the manipulation and to shorten the time of treatment of biopsy material by more than 24 hours, thereby enabling the investigator to give the conclusion about the state of the medullar hemopoiesis on the same day. The principle of the method consists in combining the stages of fixation and decalcification and also in acceleration of the final stage of treatment of the trephined bone marrow due to electrodecalcification of the osseous tissue.

Biopsy↗