INCIDENTALLY DIAGNOSED BICYTOPENIA SHOWING A WIDE SPECTRUM OF PATHOLOGIES ON BONE MARROW MORPHOLOGY

ABSTRACT
Objective: Spectrum of bone marrow morphology in patients incidentally diagnosed as bicytopenia on routine hematological
workup.
Study design: Descriptive study.
Place and duration of study: This study was carried out over a period of one year and six months (January 1st 2013-
June, 30th 2014) at Pathology Department, Saidu Medical College, Saidu Sharif Swat.
Methods and Materials: Total of 100 cases of both sexes and all age groups presenting with bicytopenia on blood
counts referred for bone marrow analysis were included in the study.
Results: Total of 100 cases with bicytopenia on blood counts underwent bone marrow aspiration. Age ranged from
1 year to 75 years with mean age 28.1±23.55 years. Male to female ratio was 1.5:1. Out of these bicytopenias the
most common was anemia and thrombocytopenia (85% cases) followed by anemia and leukopenia (10% cases) and
thrombocytopenia and leukopenia (5% cases). The most common bone marrow diagnosis was megaloblastic anemia
(18% cases) followed by mixed nutritional deficiency anemia (17% cases), acute lymphoblastic anemia (14% cases),
hemolytic anemia (10% cases), iron deficiency anemia (8% cases), hypoplasia (6% cases), visceral leishmaniasis (6%
cases), acute myeloid leukemia, myelodysplastic syndrome (5% cases each), sepsis, multiple myeloma, malaria (3%
cases each) and chronic myeloid leukemia (2% cases).
Conclusion: Bicytopenia is one of the common findings on blood counts, in the present study the most common cause
on bone marrow analysis was found to be nutritional deficiency anemias in all age groups while acute lymphoblastic
leukemia was the commonest cause in pediatric group. The present study will provide basis for further studies in category
of bicytopenia especially in adult population because not much data is available in adult population.
Keywords: Peripheral cytopenia, bicytopenia, anemia, thrombocytopenia, leukopenia, megaloblastic anemia, mixed