Monica GUPTA, Shivani MALİK, Rajnish KALRA, Nisha SHARMA, Sunita SINGH, veena GUPTA, Promil JAIN, Rajeev SEN

Etiological Profile of Plasmacytosis on Bone Marrow Aspirates

Amaç: Son yıllarda rutin kemik iliği aspiratı incelemele- rinde saptanan neoplastik ve non-neoplastik hastalıklarda giderek artan oranlarda plazma hücrelerine rastlanmakta- dır. Bu çalışmada kemik iliği aspiratında plazmasitoz sap- tanan durumların bir spektrumu çıkarılmaya çalışılmıştır. Yöntemler: Sunulan çalışma bir yıllık süre içinde Patolo- ji Bölümünde gerçekleştirildi. Çalışma materyalini artmış oranda plazma hücresi (>%3,5) gösteren toplam 114 ke- mik 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 40lı 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 immunelektro- forez ve immunhistokimya ile boyanmış kemik iliği aspira- tı incelemesi ile sonuç tanısı konabilir ve hasta yönetimi gerçekleştirilebilir.

Kemik İliği Aspiratlarında Saptanan Plazmasitozun Etyolojik Profili

Objective: In recent years, during routine examination of bone marrow aspirates, an increased plasma cell per- centage 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 condi- tions with plasmacytosis in bone marrow. Methods: The present study was conducted in the de- partment of pathology over a period of one year. A total of 114 bone marrow aspirates that showed increased plas- ma 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

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