HISTOPATHOLOGICAL OUTCOME OF PANCYTOPENIA CASES ON BONE MARROW TREPHINE BIOPSY

Pancytopenia on Bone Marrow Trephine Biopsy

Abstract

Objective: To determine the histological outcome of pancytopenia cases on bone marrow trephine biopsy and to see the frequency of various causes of pancytopenia in our population.
Study Design: Descriptive study.
Place and Duration of Study: Pathology department, Combined Military Hospital (CMH), Kharian (Pakistan). One year (Jan 2015–Dec 2015).
Material and Methods: Two hundred bone marrow trephine biopsies were done in one year (2015), out of which 40 were done for evaluation of pancytopenia. The criteria for diagnosis of pancytopenia were; haemoglobin less than 10 g/dl, total leukocyte count (TLC) less than 4.0 x 109/l and platelet count less than 100,000 x 109/l. Patients with pancytopenia secondary to drugs, chemotherapy and radiotherapy were excluded from the study. Trephine biopsies showing marked crushing and having inadequate material were also excluded from the study. Biopsies were processed, slides made and examined under light microscope by haematologist and histopathologist. Frequencies of various causes of pancytopenia diagnosed on histopathology were calculated. The findings were analyzed by using SPSS version 10.0.
Result: Out of 40 cases of pancytopenia, male to female ratio was 3:2. The age range was between 1 year to 75 years. Histopathological analysis of bone marrow trephine biopsies revealed megaloblastic anaemia as the most common cause of pancytopenia (30%), followed by aplastic anaemia (25%) and hypersplenism (15%).
Conclusion: Megaloblastic anaemia is the most common cause of pancytopenia in our population as compared to aplastic anaemia mentioned in most of the international studies. This indicates prevalence of nutritional deficiency in our population and megaloblastic anaemia must be kept at top of list while evaluating pancytopenia cases. Early diagnosis and treatment of megaloblastic anaemia will prevent any further complication of this disease.