Diagnostic importance of bone marrow examination in non-hematological disorders

Objective: To evaluate the frequency of involvement of bone marrow with non-haematologic disorders and to observe the significance of bone marrow examination in establishing primary diagnosis of the same. Methods: It was a descriptive study that extended from January 2003 to September 2005. A total of 4569 bone marrow aspirate and trephines were reported during this period. Only the non-haematological disorders were analyzed for their clinical and laboratory parameter. Results: During the study period, 63 patients (1.4%) were diagnosed to have non-haematological diseases detected primarily through bone marrow examination. The mean age of patients at time of procedure was 33 years (range 6 months to 89 years), with male to female ratio of 3.2:1. Anaemia was the most frequent clinical finding followed by splenomegaly and weight loss. In adults metastatic tumors were the commonest disorder, followed by chronic granulomatous disease/reaction. However in children, storage disorders were more prevalent followed by haemophagocytosis as the second commonest non-haaematological disease. Conclusion: Metastatic solid tumors were the frequent non-hematologic disorder involving bone marrow in adult patients while storage diseases were most common among children. Hence, bone marrow examination is a useful laboratory tool in asserting the diagnosis of various non-haematological malignancies and other miscellaneous disorders.