BONE MARROW ASPIRATE FINDINGS IN CASES OF HEPATOSPLENO-MEGALY AT A TERTIARY CARE CENTRE
Objective: To determine the bone marrow aspirate findings in cases of hepatosplenomegaly.
Material and Methods: It was a cross sectional descriptive study done in the pathology department, Khyber Teaching Hospital, Peshawar. The study was conducted from January to December 2016 (one year duration). Total 352 cases were referred to the pathology department for bone marrow aspiration during this period. Out of these, 124 cases had hepatosplenomegaly. Bone marrow aspiration and biopsy were performed, slides were stained and reported by the consultant pathologist. Cases with inadequate bone marrow aspirate were excluded from the study. Mean and standard deviation were calculated for quantitative variables. Frequency and percentages were calculated for qualitative variables.
Results: Out of 124 cases with hepatosplenomegaly, 8 had diluted aspirate and thus inadequate to make final diagnosis. Additionally, no specific diagnosis was possible in another 24 cases. So, these 32 cases were excluded and remaining 92 cases were included in the study. Age of the study sample ranged from 9 months to 72 years with mean of 36±17. Regarding gender distribution, 51 (55 %) were male and 41 (45 %) female with male to female ratio of 1.2:1. The commonest diagnosis was acute lymphoblastic leukemia, followed by reactive marrow and acute myeloid leukemia (seen in 24 %, 13 % and 9.7 % cases respectively). Less common causes included essential thrombocythemia, chediak hegashi syndrome and myelodysplastic syndrome.
Conclusion: There is a wide spectrum of bone marrow findings in cases of hepatospenomegaly. Acute lymphoblastic leukemia is the commonest bone marrow finding in cases with hepatosplenomegaly in our study. Bone marrow biopsy is a reliable diagnostic tool to give the definitive diagnosis in the cases with hepatosplenomegaly whether it is hematological or non-hematological in origin.
Key Words: Hepatosplenomegaly, Acute lymphoblastic leukemia, Bone marrow aspiration, Reactive marrow, Chediak hegashi syndrome.