Our approach to bone marrow biopsies in cytopenia

Quentin Le Clef, Thomas Menter, Alexandar Tzankov*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Citations (Web of Science)

Abstract

Unexplained cytopenia is one of the most common indications for performing trephine bone marrow (BM) biopsy (BMB). The histopathological examination in this regard must be seen in the broader context of a multimodal approach in order to reach an as entity-specific as possible diagnosis, considering medical history, physical examination, laboratory data, peripheral blood morphology, BM aspiration smear, flow cytometry results and, if indicated, cytogenetics and molecular genetics. The particular irreplaceability of the histopathological work-up and the expectations to the BMB lie especially in the detection of fibrosing and/or focal processes (e.g. localized islets of blasts) and disorders extrinsic to the BM such as e.g. metastases, thrombotic microangiopathies, granulomatous myelitides etc. We propose a systematic combined histopathological pattern-based and blood count-based approach that can be applied in such circumstances to achieve a precise diagnosis or, at least, a clinically useful differential diagnosis, particularly taking into consideration specific morphologic pitfalls and application of ancillary techniques. Constitutional BM failure syndromes will not be profoundly addressed.

Original languageEnglish
Article number152447
Number of pages9
JournalPathology Research and Practice
Volume215
Issue number7
DOIs
Publication statusPublished - Jul 2019

Keywords

  • Bone marrow biopsy
  • Reactive cytopenia
  • Pancytopenia
  • Anemia
  • Neutropenia
  • Thrombocytopenia
  • HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS
  • CLONAL HEMATOPOIESIS
  • ANEMIA
  • MANIFESTATIONS
  • CLASSIFICATION
  • DEFICIENCY
  • MANAGEMENT
  • MUTATIONS
  • DIAGNOSIS
  • LEUKEMIA

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