A Comparative Study Of Bone Marrow Aspiration Smear And Cell Block Using Romanwasky And Hematoxylin And Eosin Stain

摘要

Background: Bone marrow aspirate is a cytologic preparation of bone marrow cells obtained by aspiration of marrow and a smear of the cells. Aspiration of the marrow has been utilized for cytological assessment, with analysis directed toward morphology and differential cell count. The use of H&E and Romanowsky group of stains in the bone marrow analysis are very important and allow for studies of marrow’s overall cellularity, detection of focal lesions and extent of infiltration by various pathological entities. Objectives: To compare efficacy of Romanowsky group of stains (Geimsa and Leishman) in bone marrow aspiration smears with paraffin embedded cell blocks section. Methods: The present study was done Hamidia Hospital, Bhopal. Department of Pathology from May 2008 to Sep. 2009. 83 cases in which complete peripheral blood smears, bone marrow and cell blocks was available were included in the study. Bone marrow aspiration was performed, Cell block was prepared & smears were stained with Leishman stain and Geimsa stain. Quality Index of all slides were calculated and compared. Results: Comparison was done between bone marrow aspirate smears stained by Romanowsky group of stains (Leishman & Giemsa) and paraffin embedded cell block section stained by Hematoxylin & Eosin stain. Out of 83 cases, there were 60 cases (72.2%) of anaemias, 9 (10.8%) platelet disorders, 6 (7.2%) Acute Leukaemias, 3(3.6%) shift to left, 2 (2.4%) Lymphoproliferative disorders, 1 (1.2%) MDS, 1(1.2%) Leishmaniasis and 1 (1.2%) hyperspleenism. Conclusions: The overall staining quality is superior in Leishman stain than in Giemsa stain. H&E stained are particularly helpful in hypocellular marrow aspirate. Introduction The bone marrow is one of the body’s largest organs. It constitutes 4.5% of the total body weight and weights 3375 grams in a 75 kg individual1. The hematopoietic bone marrow is organized around the vasculature of the bone cavity. The main function of the bone marrow is to supply mature hematopoietic cells for circulating blood in a steady-state as well as to respond to increased physiologic or pathologic demands.Recent advances in the treatment of hematologic malignancies have been paralleled by renewed interest on the part of pathologists and hematologists in methods of obtaining and preparing bone marrow for diagnostic studies.Bone marrow aspirate is a cytologic preparation of bone marrow cells obtained by aspiration of marrow and a smear of the cells. Bone marrow aspirate smears are primarily used for the assessment of differentia count, maturational status, morphologic details, myeloid-to-erythroid (M:E) ratio. Bone marrow aspirated cell blocks provide a better and more detailed estimate of bone marrow cellularity. They are particularly useful for patients with aplastic / hypoplastic marrow. Aspiration of the marrow has been utilized from cytologic assessment, with analysis directed toward morphology and obtainment of differential cell count. “Romanowsky Stain”is a general term which includes several specific stains or stain combinations. Romanowsky (Giemsa & Leishman) stains are routinely used in hematology2 In H&E stained sections of bone marrow, the more mature stages of the erythroid and myeloid cells, adipocytes and megakaryocytes can be identified. However lymphoid cells as well as immature progenitor cells cannot be reliably identified. The use of H&E and Romanowsky group of stains in the bone marrow analysis are very important and allow for studies of marrow’s overall cellularity, detection of focal lesions and extent of infiltration by various pathological entities. Bone marrow studies aid in the diagnosis, staging and monitoring of several diseases Thus the present study was being conducted to compare efficacy & to explore further utility of Geimsa and Leishman stains of Romanowsky group in bone marrow aspiration smears. Objectives The present study was undertaken with the objectives – Materials And Methods The present study was