Delacrétaz F, Schmidt P M
Schweiz Med Wochenschr. 1979 Jan 6;109(1):13-8.
Bone marrow was simultaneously obtained by aspiration and by biopsy in a series of 200 patients in order to evaluate the potential usefulness of pathological-anatomical examination (paraffin-embedding technique). Conditions studied included search for lymphomas (26.5%), multiple myelomas (24.5%) and metastases (7.5%) and the evaluation of myeloproliferative syndromes (17.5%) and other hematological disorders such as cytopenias, anemias and leukemias (24%). In 76% of the cases the two methods of evaluation were equivalent. Nevertheless, comparison of the cytological and histological methods provided a greater measure of diagnostic confidence. In 24 cases (12%) the bone biopsy was the only diagnostic procedure; these comprised partly dry aspirations and partly bone marrow smears in which the specific lesion was not represented. Bone marrow aspiration proved superior in 24 cases (12%) in view of the better detection of small and discrete malignant infiltrates and more detailed analysis of blasts and cytological changes in cell maturation. On the basis of the techniques employed in this series of 200 patients, a combination of the two investigations appears to be indispensable for the evaluation of lymphoand myeloproliferative syndromes, of cytopenias with or without fever of unknown origin, and in the search for metastatic disease.
为评估病理解剖检查（石蜡包埋技术）的潜在实用性，对200例患者同时进行了骨髓穿刺和活检。研究的病症包括寻找淋巴瘤（26.5%）、多发性骨髓瘤（24.5%）和转移瘤（7.5%），以及评估骨髓增殖性综合征（17.5%）和其他血液系统疾病，如血细胞减少症、贫血和白血病（24%）。在76%的病例中，两种评估方法等效。然而，细胞学和组织学方法的比较提供了更高的诊断可信度。在24例（12%）病例中，骨髓活检是唯一的诊断方法；其中部分是干抽，部分是骨髓涂片未显示特定病变。鉴于能更好地检测微小和离散的恶性浸润以及更详细地分析原始细胞和细胞成熟过程中的细胞学变化，骨髓穿刺在24例（12%）病例中被证明更具优势。基于对这200例患者所采用的技术，对于评估淋巴和骨髓增殖性综合征、伴有或不伴有不明原因发热的血细胞减少症以及寻找转移性疾病而言，两种检查相结合似乎必不可少。
