Contemporary biopsy and flow-cytometry analysis of bone marrow: Which technique is of diagnostic superiority

Background: Comparative scientific investigations of the diagnostic sensitivity and specificity of biopsy and flow cytometry of bone marrow have been seldom performed. Contemporary investigations with plastic embeddings of not decalcified material do not exist until now. Patients and Methods: Contemporary biopsy and flow-cytometric investigations were employed in a total of 431 patients. Biopsies were resin embedded and analyzed by light microscopy. In addition, anticoagulated bone marrow was aspirated within the same session. Flow cytometry was performed using a panel of antibodies to distinguish specifities of granulopoiesis, and lymphatic subpopulations. Results: Flow cytometry was of diagnostic adventage in acute leucemias and Sezary's syndrome. It can be helpful in cases of hairy cell leukemia, mantle cell lymphoma and minimal residual infiltrations of bone marrow. However, in the majority of the cases, histology resulted significantly in more accurate diagnoses. Best results were obtained, when both methods have been combined. Conclusions: Pathologists should re-integrate flow cytometry into hematological diagnostic procedures.