The Role of Bone Marrow Aspiration and Bone Marrow Biopsy in Diagnosis of Bone Marrow Metastases

Background: Bone marrow is the site of many malignant disorders and it is one of the common places for solid tumors to metastasize. Examination of the bone marrow aspirate and biopsy is a routine procedure performed for assessment of various conditions such as cytopenias, hematologic neoplasms, nonmalignant disorders and metastatic neoplasms. Methods: The patients were referred to the Hematology Department at Tishreen University Hospital. 236 patients enrolled the study. Both bone marrow aspiration and biopsy were performed for all patients. Bone marrow aspirate was interpreted by the hematologist and the biopsy was examined by a Histopathologist. Moreover, we used immunohistochemical staining of some bone marrow biopsy specimens in cases where more information for diagnosis is required.  Results: Bone marrow metastases was diagnosed in 35 (14.83%) samples. Prostate, breast, stomach, lung and neuromuscular cancers were metastasized to bone marrow in 11, 9, 7, 6 and 2 cases, respectively. Bone marrow biopsy could discover the metastasis in 100% of the involved cases, while only 40% of the cases with bone marrow involvement were diagnosed by bone marrow aspiration. The degree of sensitivity of bone marrow biopsy for diagnosis of bone marrow metastases in comparison to aspiration was statistically significant (P=0.001). Conclusion: Bone marrow Metastases were diagnosed in 14.83% of the patients with malignant tumors. Prostate and breast cancer were the most common. Bone marrow biopsy could diagnose the metastases in all the cases compared to 40% by bone marrow aspiration.