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PubMed1994

[Needles for bone marrow examination].

Over the past decades, numerous new bone biopsy needles have been introduced. Pathological investigation requires sufficiently large and well-preserved specimens. This article reviews the literature concerning the quality of the instruments. Comparison of the various types of needles in controlled studies is not available. Bone-marrow biopsy is discussed in the context of obtaining optimal specimens and choice of biopsy needle.

Biopsy, Needle↗
PubMed1981

Bronchoscopy and bone marrow examinations. An efficient strategy to establish the diagnosis of small cell carcinoma of the lung.

The utility of various diagnostic procedures, including fiberoptic bronchoscopy and bone marrow aspirate/biopsy for small cell carcinoma, was examined in 150 patients. From a chart review of the first 100 patients, 55 required an invasive procedure such as mediastinoscopy or thoracotomy to establish the tissue diagnosis. In 50 consecutive prospective patients, only four required an invasive procedure for tissue confirmation. Eighteen of the 50 prospective patients had positive iliac crest bone marrow aspirates or biopsies diagnostic for small cell carcinoma. Fiberoptic bronchoscopy was nondiagnostic in 15 prospective patients, but the bone marrow examination was diagnostic in 12 of this subgroup. The combination of fiberoptic bronchoscopy and bone marrow examination in patients with centrally located small cell carcinoma greatly reduced the need for more expensive and invasive diagnostic procedures.

Adult↗
PubMed1991

Bone marrow examination in small cell lung cancer--when is it indicated?

To assess the usefulness of bone marrow (BM) examination performed as part of the staging procedure in SCLC, 137 patients with this neoplasm were studied. At diagnosis, BM was infiltrated in 23 patients (17%) and in 5 of them (22%) it was the only metastatic site. BM examination changed the previously given stage in 9% of the patients who were supposed to have limited disease before this test was performed. BM involvement correlated with a higher frequency of bone (p less than 0.05) and liver (p less than 0.01) metastasis. Correlations were found neither with blood or serum biochemistry disturbances nor with postchemotherapy haematologic toxicity. The BM positive patients had a survival rate similar to those with extensive disease but without BM infiltration. We conclude that BM examination should be performed only when no other metastatic sites have been found after a complete staging study.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

Role of bone marrow examination in staging Hodgkin's disease: experience in México.

We assessed the value of bone marrow biopsy prospectively in a group of 91 individuals with Hodgkin's disease. The median age of our population was 29 years (range 4-87 years); 59 were males. Most patients (45%) had nodular sclerosing disease and most patients (44%) were in pathological stage II at diagnosis. The bone marrow biopsy showed infiltration by Hodgkin's disease in only three individuals (3.3%); two of these patients displayed constitutional symptoms and had been assigned to stage III before the biopsy. In one case, bone marrow biopsy was the diagnostic procedure, which was performed as part of the investigation of fever of unknown origin. Follow-up periods ranged between 1 and 117 months (median 16 months). All patients achieved complete remission, seven patients relapsed and four were given autologous stem cell transplants. The median survival of the whole group was 117 months, while the 3500-day survival was 76%. As bone marrow biopsy was the diagnostic procedure in one case, bone marrow biopsy was a useful staging procedure in only 2.2% of patients (two out of 90 patients). We suggest that bone marrow biopsy should be only be performed as a staging procedure in a selected subset of patients with Hodgkin's disease (clinical stage III, B symptoms, etc.).

Adolescent↗
PubMed2005

Profile of bone marrow examination in HIV/AIDS patients to detect opportunistic infections, especially tuberculosis.

Morphological evaluation of 140 bone marrow aspirations received in haematopathology laboratory with serologically established HIV infection, along with other relevant special haematological tests, was done during 1st Jan 1999 - 31st Dec 2002 at state government run tertiary care General Hospital in Maharashtra state, India. Out of 140 cases: 118 (84.28%) patients had anaemia, 25 (17.86%) had leukopenia, while 13 (9.28%) were thrombocytopenic. Dyserythropoiesis was present in 18 (12.86%) cases, dysmyelopoiesis 37 (26.43%) and micromegakaryocytes were noted in 44 (31.43%) cases. Haemophagocytosis was evident in 8 (5.71%) cases. Plasmacytosis encountered in 120 (85.71%) cases was a common feature. Based on clinical profile and results of other investigations 56 (40%) patients were clinically diagnosed to be of Mycobacterium tuberculosis (TB). Of these, 18 (12.86%) bone marrow aspirates were positive for AFB, Mycobacterium tuberculosis. In 4 cases cryptococci were demonstrated (Mucicarmine stain). There was one case each of Histoplasma capsulatum and leishmaniasis. One patient showed dense parasitemia with Plasmodium falciparum. One patient had immunoblastic lymphoma and showed bone marrow infiltration. Findings in this study strongly indicate that in HIV/AIDS, AFB stain should be done on each marrow aspirate to rule out tuberculosis in countries like India; where TB and AIDS are marching together.

AIDS-Related Opportunistic Infections↗
PubMed1995

Magnetization transfer in hemopoietic bone marrow examined by localized proton spectroscopy.

The sensitivity of hemopoietic bone marrow to magnetization transfer is analyzed in 15 healthy volunteers and seven patients with different hematological disorders (inflammation, plasmacytoma, hemopoietic reconstitution after bone marrow transplantation). To obtain sufficient signal-to-noise ratio, a 90 degrees - 180 degrees - 180 degrees double spin echo (PRESS) single voxel spectroscopic method was combined with pulsed magnetization transfer. Several spectra were recorded from each volume element inside the vertebral marrow, alternately with and without prepulses for magnetization transfer. Water signals from marrow with increased content of extracellular water due to inflammation or edema revealed less magnetization transfer effects than marrow with increased intracellular water content due to high cellularity. The preliminary results show magnetization transfer to be a promising tool for the clinically important characterization of the water composition in red bone marrow.

Adult↗