COMPARATIVE UTILITY OF DIAGNOSTIC BONE-MARROW COMPONENTS - A 10-YEAR STUDY

Ten years of cumulative experience represented by 4,902 consecutive di agnostic bone-marrow examinations at a tertiary care and referral cent er were reviewed to assess the value of specific components. While it has been shown previously that the information obtained from each comp onent is generally complementary, the inclusion of some or all compone nts may vary between institutions. The components studied included asp irate smears, clot sections, biopsy cores, and touch imprints of biops y and clot sections. Three clinical presentations accounted for the ma jority of cases: staging for carcinoma or lymphoma, cytopenias, and ac ute leukemia. We conclude that bilateral aspirates with biopsies are r equired for diagnosis in staging of neoplasms and that a unilateral as pirate with biopsy is sufficient to assess patients with cytopenia or leukemia. Only rarely were touch imprints of biopsy cores necessary to establish a diagnosis; however, their early availability prior to exa mining sections of the clot and core did provide immediate information , when positive, in the staging of patients with carcinoma. In a small percentage of staging and leukemia cases the diagnosis rested with th e clot section alone. The findings in this study address common assump tions associated with routine diagnostic hematology and oncology proce dures, and are important to both clinicians and pathologists concerned with accuracy, quality assurance, turnaround time, and cost containme nt. (C) 1997 Wiley-Liss, Inc.