Histological and immunohistochemical aspects of marrow bone biopsies evaluated from 2011 to 2013 in two general pathology laboratories: difficulties, advantages and conclusions

Abstract

Objective: Bone marrow biopsies gained importance and began to collaborate effectively with the bone marrow punctures performed by hematologists, after the significant improvement in the use of immunohistochemistry in paraffinembedded material. This examination requires clinical discussion of cases between pathologists and hematologists, since hematopoietic diseases are a challenge for the general pathologist. Material and Method: This research studied 190 results of immunohistochemical tests and the histological diagnoses of all bone marrow biopsies performed in two general pathology laboratories of Sorocaba, state of São Paulo, Brazil, from 2011 to 2013. Results and Discussion: The distribution of the frequencies of diagnoses found follows the literature standards. However, the greatest difficulty to reach these diagnoses was the lack of clinical data, such as age, clinical/laboratory data and diagnostic hypotheses, which should be included in the test requests and contribute to the analysis of the pathologist. The use of immunohistochemistry was confirmed as the main facilitating factor, essential for the correct diagnosis. The accuracy of the diagnosis of bone marrow diseases is important to determine the treatment of patients and to predict better or worse prognosis factors. Conclusion: This study found that the association between the test pathology and immunohistochemistry, in addition to clinical and laboratory data, should be present in the routine evaluation of bone marrow biopsies.