The role of trephine needle bone marrow biopsy in the evaluation of various haematological and non-haematological diseases At Kenyatta National Hospital, Nairobi

Citation:
Rajab JA. The role of trephine needle bone marrow biopsy in the evaluation of various haematological and non-haematological diseases At Kenyatta National Hospital, Nairobi.; Submitted.

Abstract:

This is a descriptive retrospective and prospective
study of 101 patients admitted to Kenyatta National Hospital
(KNH) between 1st October, 1985 and 30th January, 1990 and
had bone marrow examination done by aspiration and trephine
needle biopsy. At KNH trephine needle bone marrow (TNBM)
biopsy has been performed over the years when aspiration
results in 'dry tap'. It is only available for the use by a
few specialists (haematologists) and it is rarely performed
in staging malignant lymphomas or as a routine diagnostic
technique in various other diseases. The study was done to
evaluate the role of the technique in patient care at this
hospital. The relevant data and the diagnostic outcome of
50 patients admitted to the hospital between 1st October,
1985 and 30th June, 1989 were collected retrospectively.
Trephine needle biopsies were performed by the investigator
on 51 patients during the last 7 months of the study. Data
collected included: the age and sex, the indications for
bone biopsy, the quality of the specimen, the reporting
format and the final diagnosis on the trephine biopsies.
The 101 patients studied were between 2 and 75 years of
age. The mean age was 23.9 years. There were 62 males and
39 females. A 'dry tap' aspirate, the commonest indication
for TNBM biopsy was reported in 37 (36.6%) cases. In twelve
cases, the aspirate and needle biopsy were performed at the
same time using the same needle. Ten of these were in the
staging of malignant lymphomas. Good or satisfactory
specimens were obtained in at least 86% of the biopsies

performed. Aplastic anaemia, the commonest abnormality
detected was found in 28 (27.7%) of the patients studied. A
review of the reporting format showed that in only 20% cases
in the retrospective study was a full report of the biopsy
given by the haematologist.
This study shows that TNBM biopsy is a simple and safe
procedure yielding a good or satisfactory specimen in most

instances. The biopsy will most likely provide a diagnosis
when bone marrow aspirate fails due to 'dry tap' or scanty
yield. The procedure may be of value in routine
investigation of various diseases such as aplastic anaemia
and in staging of malignant lymphomas although larger
studies need to be done in this area (only ten cases in this
study). A standard format should be formulated and adhered
to by haematologists and pathologists reporting on the TNBM
biopsies in this hospital.

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