Objectives: This study was carried to identify the underlying etiopathology of pancytopenia and to find out the bone marrow morphology of aspiration smears.This study was conducted over a period of 12 months in the department of pathology. Bone marrow aspiration smears of patients fulfilling the criteria of pancytopenia and other hematological malignancies were examined. 70 cases underwent bone marrow aspiration mean age was 30 years (range 21 days to 80 years) 5 cases were children (3.5%), males 33 (23.1%), females 32 (22.4%). Male: Female ratio was1.03:1 .The commonest cause was erythroid hyperplasia seen in 28 cases (19.6% ) followed by normocellular marrow in 19 cases(13%), hematological malignancies in 9 cases( 6.3%) and Cryptococcus in 1 cases(0.7%).Multiple myeloma was the commonest hematological malignancy constituting 4 cases of all hematological malignancies . In children, commonest finding was normal bone marrow, while in adults erythroid hyperplasia was commonest finding followed by 9 cases of all hematological malignancies. The present study was carried out to determine the cause of pancytopenia and also establish diagnosis in other hematological malignancies. Bone marrow examination was able to establish diagnosis in 70 cases.Erythriod hyperplasia was the commonest diagnosis, followed by normocellular marrow and hematological malignancies. Introduction Bone marrow examination is an established diagnostic modality in the evaluation of various hematological disorders. In case of ineffective hematopoiesis the marrow may be normocellular or hypercellular (11).Bone marrow examination is extremely helpful in evaluation of pancytopenia .The presenting symptoms are attributed to the anemia or the thrombocytopenia. Leucopenia is often seen in subsequent course of the disorder (13).Pancytopenia is defined by reduction in all three formed elements of blood below the normal reference range (11). Varieties of hematological and non- hematological disorders may affect bone marrow either primarily or secondarily, resulting in the manifestation of pancytopenia (14).The incidence of various hematological disorders causing pancytopenia varies due to geographical distribution and genetic predisposition (9). The management and prognosis of pancytopenia depends on the underlying etiopathology. Hence the finding of correct etiopathology in a given case is crucial. For this purpose, the objective of this study was to find the underlying etiopathology of pancytopenia. Methods and Materials This study was carried out for 12 months in the department of pathology. A total of 70 cases of bone marrow examination were carried out on patients with peripheral blood examination revealing (32) pancytopenia ,(17) microcytic hypochromic anemia,(10) normocytic normchromic blood picture ,(4 ) multiple myeloma , (3 ) dimorphic anemia,( 2) chronic myeloid leukemia , (1) bicytopenia and(1)leukoerythroblastic blood picture .The criteria for pancytopenia were hemoglobin (Hb) < 10g/dl, total leucocytes count (TLC) < 4000/cumm and platelet count < 1 lakh/cumm.Bone marrow aspiration was performed using klima needle from posterior superior iliac spine in all 70cases and trephine biopsies was performed using jamshidhi needle in 25 cases .A complete blood count was done using hematology auto analyzer . Peripheral smear examinations were performed in all 70 cases .Iron studies were done in few cases of microcytic hypochromic anemia.Evaluation of slides;The cellularity, differential counts and megakaryocytic density were done on all bone marrow samples and recorded in a proforma. They were assessed subjectively. The cellularity was graded as hypocellular, normocellular or hypercellular. Multiple areas of each slide were screened and an estimate was made. Samples were evaluated for the presence of iron, tumor staging and presence of tumor cells. Results This study was carried out for 12 months in the department of pathology. The total numbers of bone marrow examina
展开▼
