EVALUATION OF BONE MARROW ASPIRATE, TREPHINE BIOPSY AND IMMUNOHISTOCHEMISTRY IN NON- HAEMOPOIETIC MALIGNANCIES
DOI:
https://doi.org/10.69656/pjp.v21i1.1771Keywords:
Metastatic tumor, immunohistochemistry, Bone Marrow, Trephine BiopsyAbstract
Background: Bone marrow involvement in non-haematopoietic malignancies is rare but clinically significant. Accurate diagnosis is crucial for assessing disease progression and prognosis. This study evaluates the diagnostic effectiveness of bone marrow aspiration and trephine biopsy in detecting non-haematopoietic malignancies. Objective of this study was to assess bone marrow aspiration and trephine biopsy findings in metastatic solid tumours and confirm diagnoses using immunohistochemistry. Methods: This cross-sectional study was conducted at Pathology (Haematology) Department, Pak Emirates Military Hospital, Rawalpindi, from Apr 2021 to Jun 2023. Data were collected from patients undergoing bone marrow biopsy who were provisionally diagnosed with metastatic solid tumours. Statistical analysis was performed using SPSS-22, with quantitative data expressed as Mean±SD and qualitative data as frequencies and percentages. Chi-square test was applied and p?0.05 was considered statistically significant. Results: There were 21 patients in the study, 18 (85.7%) male and 3 (14.3%) female. The mean age was 63.81±11.82 years (range: 40–86). Common symptoms included pallor (52.4%), weight loss (28.6%), and fever (19.0%). Bone marrow trephine biopsy revealed metastatic tumours in 8 patients (38.1%), anaemia of chronic disease in 3 (14.3%), peripheral platelet destruction in 1 (4.8%), and reactive changes in 6 (28.26%). Conclusion: Metastatic solid tumours were found in 38.1% of cases, highlighting the importance of bone marrow evaluation in disease monitoring and prognosis. Understanding marrow metastasis patterns supports research and targeted therapies.
Pak J Physiol 2025;21(1):56–9, DOI: https://doi.org/10.69656/pjp.v21i1.1771
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References
Rani HS, Hui M, Manasa PL, Uppin SG, Uppin MS, Paul, TR, et al. Bone marrow metastasis of solid tumours: A study of 174 cases over 2 decades from a single institution in India. Indian J Hematol Blood Transfus 2021;38:8–14.
Chen P, Xu RC, Chen N, Zhang L, Zhu, J, Pan B, et al. Detection of metastatic tumour cells in the bone marrow aspirate smears by artificial intelligence (AI)-Based morphogo system. Front Oncol 2021;11:742395.
Papac RJ. Bone marrow metastases. A review. Cancer. 1994;74(9):2403–13.
Ozkalemkas F, Ali R, Ozcocaman V, Ozcelik T, Ozan U, Ozturk H, et al. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: A clinical study of 19 cases. BMC Cancer 2005;5:144.
Zach O, Lutz D. Tumour cell detection in peripheral blood and bone marrow. Curr Opin Oncol 2016;18:48–56.
Jawed MA, Paswan MK, Mahto SK, Patra S, Ashok C, Ansari MA, et al. An extensive analysis and comparison of bone marrow aspiration and bone marrow trephine biopsy at a tertiary care hospital in Jharkhand for various hematological and non-hematological illnesses. Cureus 2024:16(6):e62661.
Dillekas H, Rogers MS, Straume O. Are 90% of deaths from cancer caused by metastases? Cancer Med 2019;8:5574–6.
Gajendra S, Sharma R. Cytomorphological evaluation of non-haematopoietic malignancies metastasizing to the bone marrow Am J Blood Res 2023;13(1):1–11.
Kaur G, Basu S, Kaur P, Sood T. Metastatic bone marrow tumours: study of nine cases and review of the literature. J Blood Disord Transfus 2011;2:110.
Khan MI, Rasheed A, Iqbal S. Bone marrow aspiration versus trephine biopsy: diagnostic value of both modalities when done simultaneously. Professional Med J 2021;28(12):1844–9.
Hung YS, Chou WC, Chen TD, Chen TC, Wang PN, Chang H, et al. Prognostic factors in adult patients with solid cancers and bone marrow metastases. Asian Pac J Cancer Prev 2014;15(1):61–7.
Kucukzeybek BB, Calli AO, Kucukzeybek Y, Bener S, Dere Y, Dirican A, et al. The prognostic significance of bone marrow metastases: evaluation of 58 cases. Indian J Pathol Microbiol 2014;57:396–9.
Chauhan K, Jain M, Grover S, Shukla P, Rusia U, Grover RK. Bone marrow metastasis in nonhematologic malignancies: Data from a cancer hospital. Clin Cancer Investig J 2016;5:103–9.
Arya L, Sundriyal D, Bhandari R, Srivastava R, Sehrawat A. Bone marrow metastases from solid organ cancer in adults. Indian J Surg Oncol 2021;12(3):545–8.
Assi R, Mukherji D, Haydar A, Saroufim M, Temraz S, Shamseddine A. Metastatic colorectal cancer presenting with bone marrow metastasis: a case series and review of literature. J Gastrointest Oncol 2016;7:284–97
Kawashima I, Fukasawa H, Kasai K, Kumagai T, Koshiishi M, Nakajima K, et al. Bone marrow invasion of small cell neuroendocrine carcinoma of the endometrium: a diagnostic pitfall mimicking a haematological malignancy. Intern Med 2019;58:2561–8
Ekinci AS, Bal O, Ozatli T, Turker I, Esbah O, Demirci A, et al. Gastric carcinoma with bone marrow metastasis: A case series. J Gastric Cancer 2014;14:54–7.
Atac B, Lawrence C, Goldberg SN. Metastatic tumour: the complementary role of the marrow aspirate and biopsy. Am J Med Sci 1991;302:211–3.
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Copyright (c) 2025 Aiza Saadia, Maham Arshad, Sunila Tashfeen, Sidra Naveed, Warda Furqan, Fahad Ahmed
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