ISSN 2997-1036
International Journal of Hematology | Vol. 2, No. 3, March 2011 | pp. 17–24
DOI: 10.46882/2011/IJH/000015
Original Article
Title: Bone marrow morphological patterns in adult patients with unexplained cytopenias: A 5-year retrospective audit
Names of Authors: F. K. Yusuf¹, G. O. Eze², H. A. Maina³
Authors’ Affiliations: ¹Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Pathology, University of Benin Teaching Hospital, Benin City, Nigeria; ³Department of Haematology, University of Maiduguri, Maiduguri, Nigeria
Abstract: Unexplained peripheral blood cytopenias present diagnostic challenges requiring bone marrow aspirate and trephine biopsy evaluations. This 5-year retrospective audit reviewed 164 adult patients who underwent bone marrow examinations for isolated anemia, bicytopenia, or pancytopenia of uncertain etiology. Hyperplastic marrow with megaloblastic erythropoiesis was the most common morphological finding, occurring in 34.1% of cases (56 of 164), primarily due to nutritional vitamin B12 or folate deficiencies. Aplastic anemia was diagnosed in 15.2% of patients, characterized by marked hypocellularity and fatty replacement. Hematological malignancies, including acute myeloid leukemia, multiple myeloma, and myelodysplastic syndromes, accounted for 26.8% of cases. Granulomatous inflammation secondary to disseminated tuberculosis was found in 7.3% of biopsies. Trephine biopsies provided a superior diagnostic yield over aspirates alone for aplastic anemia and myelofibrosis. The findings demonstrate that nutritional deficiencies and preventable infections remain major causes of marrow failure, highlighting the diagnostic necessity of early bone marrow histology.
Keywords: Bone marrow biopsy, cytopenia, pancytopenia, megaloblastic anemia, aplastic anemia
Manuscript Timeline: Received: December 04, 2010; Revised: January 15, 2011; Accepted: February 10, 2011; Published: March 18, 2011