Etiological Profile of Plasmacytosis on Bone Marrow Aspirates

Öz

Objective: In recent years, during routine examination of bone marrow aspirates, an increased plasma cell percentage has been noted in a good number of cases which included both neoplastic and non-neoplastic diseases. An attempt has been made to observe the spectra of conditions with plasmacytosis in bone marrow.
Methods: The present study was conducted in the department of pathology over a period of one year. A total of 114 bone marrow aspirates that showed increased plasma cells (>3.5%) constitute the study material. A detailed relevant clinical examination followed by complete blood count, peripheral smear examination and bone marrow aspiration was done in all cases.
Results: There was slight female predominance with male to female ratio of 1:1.1. The majority of patients were in 4th decade. The plasma cell concentration ranged from 5% to 36%. As far as the etiology is concerned, 96 cases (84.2%) were non-neoplastic and 18 cases (15.7%) had neoplastic etiology.
Conclusion: Bone marrow plasmacytosis can present as diagnostic dilemma and some time can be challenging to differentiate reactive from neoplastic condition as there is an overlap both in counts and morphology. Each case with plasmacytosis especially in the overlap range requires complete clinical evaluation, individualized investigations and more specific tests like immunoelectrophoresis and bone marrow biopsy with immunohistochemistry to arrive at a final diagnosis for patient management.
Key words: Reactive plasmacytosis, bone marrow, multiple myeloma, megaloblastic anaemia

Anahtar Kelimeler

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Kemik İliği Aspiratlarında Saptanan Plazmasitozun Etyolojik Profili

Öz

Amaç: Son yıllarda rutin kemik iliği aspiratı incelemelerinde saptanan neoplastik ve non-neoplastik hastalıklarda giderek artan oranlarda plazma hücrelerine rastlanmaktadır. Bu çalışmada kemik iliği aspiratında plazmasitoz saptanan durumların bir spektrumu çıkarılmaya çalışılmıştır.Yöntemler: Sunulan çalışma bir yıllık süre içinde Patoloji Bölümünde gerçekleştirildi. Çalışma materyalini artmış oranda plazma hücresi (>%3,5) gösteren toplam 114 kemik iliği aspiratı oluşturmaktadır. Tüm olgularda ayrıntılı bir klinik muayene ve takiben tam kan sayımı, periferik yayma ve kemik iliği aspirasyonu yapıldı.Bulgular: Erkek / Kadın oranı açısından hafif bir kadın üstünlüğü görüldü (1 / 1,1). Vakaların çoğu 40’lı yaşlarda idi. Plazma hücre yoğunluğu %5-36 arasında değişmekte idi. Etyoloji açısından 96 (%84,2) olguda non-neoplastik, 18 (%15,8) olguda ise neoplastik bir etyoloji saptandı.Sonuç: Kemik iliği plazmasitozu tanısal bir karmaşaya yol açarak, özellikle sayı ve morfolojik görünümlerinde çakışma olan reaktif patolojilerin neoplastik durumlardan ayırt edilmesini bazen zorlaştırabilir. Özellikle çakışma aralıklarındakiler başta olmak üzere, plazmasitozlu her hastada bireyselleştirilmiş araştırmalar ve immunelektroforez ve immunhistokimya ile boyanmış kemik iliği aspiratı incelemesi ile sonuç tanısı konabilir ve hasta yönetimi gerçekleştirilebilir

Anahtar Kelimeler

• Reaktif plazmasitoz, kemik iliği, multipl miyelom, megaloblastik anemi

Kaynakça

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