International Journal of Research in Medical Sciences | March 2017 | Vol 5 | Issue 3 Page 922 International Journal of Research in Medical Sciences Ranabhat S et al. Int J Res Med Sci. 2017 Mar;5(3):922-926 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Bone marrow aspiration cytology in the diagnosis of hematologic and non-hematologic diseases in a multi-specialty hospital in Nepal Sabin Ranabhat*, Sushna Maharjan, Mamata Tiwari, Anita Bhandari, Bidur Prasad Osti INTRODUCTION Bone marrow aspiration cytology is a proven method for the evaluation of hematologic conditions, malignancies, storage disorders and some chronic systemic conditions. 1 Peripheral blood smear examination and other routine laboratory assays are not always sufficient for the diagnosis of various diseases which affect the blood and bone marrow. 2 Iron deficiency, thalassemia and some cases of anemia of chronic disease present as microcytic hypochromic anemia. 3 Bone marrow aspiration and staining the smear by Pearl's stain is the gold standard method for the diagnosis of iron deficiency anemia. Nevertheless, iron profile is preferred now-a-day because it is a non-invasive test. 4 Megaloblastic anemia presents as macrocytic normochromic anemia. Megaloblasts are found in bone marrow aspirate smear which display nucleocytoplasmic asynchrony. 5 Various types of leukemia present with blast cells in the peripheral blood smear. Bone marrow examination should be done for morphological classification of leukemia. More advanced investigations viz. Conventional Cytogenetics and FISH ABSTRACT Background: Peripheral blood smear examination and other routine laboratory assays are not always sufficient to diagnose various diseases which affect the blood and bone marrow. A bone marrow aspirate examination is essential in most of the cases. Methods: This work was a hospital-based cross sectional analytical observational study carried out in the department of pathology at the Chitwan Medical College, Teaching Hospital, Nepal, over a period of 3 years from January, 2013 to December 2015. Bone marrow was aspirated from posterior superior iliac crest under local anesthesia; sternum was the alternative site in obese patients. Univariate analysis was performed for each variable using frequency distribution and means with the help of Statistical Package for Social Sciences 20.0 (SPSS 20.0) software. Results: One hundred and fifty-nine patients were included in the study. Eight cases of 'dry tap' were excluded, for whom bone marrow biopsy was advised. Anemia was the largest group followed by malignancy, infection and miscellaneous diseases. Among anemia, megaloblastic anemia was the most common, followed by aplastic anemia, dyserythropoietic anemia and myelopthisic anemia. The category 'malignancy' consisted of leukemia, multiple myeloma and myelodysplastic syndrome. Regarding individual diseases, megaloblastic anemia was the most common haematological disorder followed by immune thrombocytopenic purpura, leukemia and aplastic anemia. Conclusions: Bone marrow aspiration cytology is a mildly invasive technique which can diagnose many haematological and non-hematologic diseases that can be confirmed by more advanced investigations, if needed: serological, biochemical or molecular. However, bone marrow sample cannot be obtained (dry tap) in a proportion of cases. In such cases, a bone marrow biopsy needs to be performed. Keywords: Bone marrow aspiration cytology, Nepal, Spectrum of diseases Department of Pathology, Chitwan Medical College, Chitwan, Nepal Received: 20 December 2016 Accepted: 28 January 2017 *Correspondence: Dr. Sabin Ranabhat, E-mail: rbhatsabin@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170637