DRY TAP: A DIAGNOSTIC ALERT FOR UNDERLYING BONE MARROW PATHOLOGY

Authors

  • Saqib Qayyum Ahmad
  • Rizwan Yusuf
  • Nadeem Zafar
  • Nadir Ali

Abstract

Background: Dry tap is an annoying experience in bone marrow (BM) findings, especially in cases where the diagnosis may hinge on BM findings. This study was conducted to determine, on the basis of bone marrow (BM) trephine biopsy, the frequency of various underlying conditions causing a dry tap, among different age groups. Methods: It was a descriptive study carried out at PAF hospital Mianwali, Pakistan from 1st Jan 2009 to 31 Dec 2012. Record of all BM aspirations and trephine biopsies performed during 4 years was retrieved from hospital’s laboratory. Total number of BM aspirations and trephines were counted and the subject’s ages and genders recorded. Frequencies and percentages of patients with dry tap, in paediatric group (<15 years of age), young to middle-aged group (15–59 years) and the elderly (≥60 years) were calculated. Diagnoses of patients with dry tap made on BM biopsy were noted for each group and their frequencies calculated. Results: Of 548 BM aspirations, dry tap was encountered in 52 (9.5%) cases. Acute lymphoblastic leukaemia (ALL) was the commonest cause of dry tap in paediatric age, seen in 6 (60%) of 10 children. In young to middle-aged group, non-Hodgkin lymphoma (NHL) was the commonest cause, found in 6 (30%) of 20 cases. NHL and metastatic tumours, seen in 8 (36.4%) and 6 (27.3%) of 22 patients respectively, were the most frequent causes of dry tap in the elderly. Conclusion: Dry tap, in most of the cases, is like a diagnostic alert for the presence of an underlying BM pathology, nature of which depends upon age group.Keywords: Bone marrow examination, biopsy, needle biopsy, lymphoma

References

Bain BJ. Bone marrow aspiration. J Clin Pathol 2001;54:657–63.

Bain BJ. Bone marrow biopsy morbidity: review of 2003. J Clin Pathol 2005;58:406–8.

Riley RS, Hogan TF, Pavot DR, Forysthe R, Massey D, Smith E, Wright L Jr, Ben-Ezra JM. A Pathologist's perspective on bone marrow aspiration and biopsy: I. Performing a bone marrow examination. J Clin Lab Anal 2004;18(2):70–90.

Humpries JE: Dry tap bone marrow aspiration: Clinical significance. Am J Hematol 1990;35:247–50.

Navone R, Colombano MT. Histopathological trephine biopsy findings in cases of ‘dry tap’ bone marrow aspirations. Appl Pathol 1984; 2:264–71.

Mukiibi JM, Paul B, Gordeuk VR. The significance of 'dry tap' bone marrow aspirations in Zimbabweans. East Afr Med J 1989;66(7):481–4.

Khanum F, Rehman A U, Ahmad S, Anwar J. “Dry tap” of bone marrow and its clinical importance. Pak J Med Health Sci 2009;2(4):292.

Bain BJ, Lewis SM. Preparation and staining methods for blood and bone marrow films. In: Lewis SM, Bain BJ, Bates I, eds. Practical Haematology, New Delhi: Elsevier, 2006; pp 59–77.

Wick MR, Mills NC, Brix WK. Tissue procurement, processing, and staining techniques. In: Mark R. Wick, ed. Diagnostic Histochemistry, New York: Cambridge University press, 2008; pp 1–27.

Riley RS, Williams D, Ross M, Zhao S, Chesney A, Clark BD, Ben-Ezra JM. A Pathologist's perspective-II. Interpretation of bone marrow aspirate and biopsy. J Clin Lab Anal 2009;23:259–307.

Hasserjian RP. Reactive versus neoplastic bone marrow. Arch Pathol Lab Med 2008;132:587–94.

Jamal S, Moghal S, Mamoon N, Mushtaq S, Luqman M, Anwar M. The pattern of malignant tumours: Tumour registry data analysis, AFIP, Rawalpindi, Pakistan (1992–2001). J Pak Med Assoc 2006;56:359–62.

Yasmeen N, Ashraf S. Childhood acute lymphoblastic leukaemia; epidemiology and clinicopathological features. J Pak Med Assoc 2009;59:150–3.

Atique M, Leghari MJ, Amin MS, Parveen S, Mushahid N, Khan MAU. Cancer data analysis in the pathology department, Combined Military Hospital, Multan, Pakistan 2002–2007. Asian Pacific J Cancer Prev 2008;9:679–81.

Brunning RD, Arber DA. Bone marrow. In: Rosai J edi. Rosai and Ackerman’s Surgical Pathology, New Delhi: Reed Elsevier, 2011; pp 1927–2012.

McKay P, Leach M, Jackson R, Cook G and Rule S. Guidelines for the investigation and management of mantle cell lymphoma. Br J Haematol 2012;159(4):1–22.

Franco V, Florena AM, Iannitto E. Splenic marginal zone lymphoma. Blood 2003;101:2464–72.

Bain BJ. Bone marrow trephine biopsy. J Clin Pathol 2001;54:737–42.

Bates I. Bone marrow biopsy. In: Lewis SM, Bain BJ, Bates I, eds. Practical Haematology, New Delhi: Elsevier, 2006; pp 115–30

Published

2015-03-01

Issue

Vol. 27 No. 1 (2015): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.