MEGAKARYOCYTIC ALTERATIONS IN THROMBOCYTOPENIA IN BONE MARROW ASPIRATION AND BONE MARROW BIOPSY: A NOVEL INSIGHT EXPERIENCE IN NORTH INDIA

Sahu Indira* and Verma Laghuta

ABSTRACT

Introduction: Thrombocytopenia is a common clinical entity that can be seen in any patient irrespective of age and have varied differential diagnosis and presents in various clinical diseases. Bone marrow study helps to differentiate and achieve a definite diagnosis with reasonable accuracy using minimally invasive technique. Aims and objective: a) To find out various conditions associated with thrombocytopenia and associated megakaryocytic changes. b) To study the megakaryocytic alterations in thrombocytopenia in the bone marrow aspiration and bone marrow biopsy and their relationship with underlying etiology. Material and methods: The study was conducted at our department of pathology at SMS Medical college from period between Jan 2018 to feb 2020. Observation and results: In this study of 74 cases, most common cause of thrombocytopenia found was MDS (33%) followed by MA (20%) and ITP (16%). 25 cases (40%) show dysplastic changes of megakaryocytes, majority of them seen in myelodysplastic syndrome (MDS). Hypolobated form were seen in 65% cases of thrombocytopenia which were mostly seen in MDS (77.7%). Among non dysplastic alterations immature form seen in 17% (11 cases),dwarf form were seen in 20% (13 cases), bare form were seen in 6% (4 cases). 4.5 % (3 cases) show budding. Conclusion: This study may be helpful in improving diagnostic accuracy in various hematopoietic disorder. As dysplastic megakaryocytes are equaly common in non MDS related thrombocytopenia so mere presence of dysplastic changes only should not be directly given diagnosis of myelodysplastic syndrome, other morphological findings, hematological parameters and complete clinical history is equally important to correlate.

Keywords: MDS, Bone marrow study, Megakaryocyte, Thrombocytopenia, Dysplastic Changes.